Journal of Substance Abuse Treatment
Volume 28, Issue 1 , Pages 67-76 , January 2005

Private insurance and the utilization of chemical dependency treatment

  • Laura A. Schmidt, Ph.D.

      Affiliations

    • Alcohol Research Group, Public Health Institute, Berkeley, CA, USA
    • Corresponding Author InformationCorresponding author. 2000 Hearst Avenue, Suite 300, Berkeley CA 94709 USA. Tel.: +1 510 642 0576; fax: +1 510 642 7175
    • ,
  • Constance M. Weisner, Dr.P.H.

      Affiliations

    • Department of Psychiatry, University of California-San Francisco, San Francisco, CA, USA

Received 5 February 2004 ,Revised 13 October 2004 ,Accepted 28 October 2004.

References 

  1. Aday LA, Anderson RA. A framework for the study of access to medical care. Health Services Research. 1974;9:208–220
  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed.. Washington, DC: Author; 1994;
  3. Andersen R. Revisiting the behavioral model and access to medical care: Does it matter?. Journal of Health and Social Behavior. 1995;36(March):1–10
  4. Booth BM, Kirchner J, Fortney J, Ross R, Rost K. Rural at-risk drinkers: Correlates and one-year use of alcoholism treatment services. Journal of Studies on Alcohol. 2000;61:267–277
  5. Booth BM, McLaughlin YS. Barriers to and need for alcohol services for women in rural populations. Alcoholism-Clinical and Experimental Research. 2000;24:1267–1275
  6. Brisson AES. Changes in a managed behavioral health care carve-out and the impact on substance abuse services. Dissertation Abstracts International. 2000;60:3187-B
  7. Buck JA, Umland B. Covering mental health and substance abuse services. Health Affairs. 1997;16:120–126
  8. Bureau of Labor Statistics. Employee benefits in medium and larger private establishments. 1995 (Bulletin No. 2496). Washington, DC: Bureau of Labor Statistics; 1998;
  9. Bureau of Labor Statistics. National compensation survey: Employee benefits in private industry in the United States, 2000 (Bulletin No. 2555). Washington, DC: Bureau of Labor Statistics; 2003;
  10. Cherpitel C. Drinking patterns and problems, drug use and health services utilization: a comparison of two regions in the U.S. general population. Drug and Alcohol Dependence. 1999;53:231–237
  11. Fox A, Garris K. The yearbook of managed behavioral health market share in the United States, 1999–2000. Gettysburg, PA: Open Minds; 1999;
  12. Frank RG, McGuire TG. A review of studies of the impact of insurance on the demand and utilization of specialty mental health services. Health Services Research. 1986;21:241–265
  13. Frank RG, McGuire TG. Estimating costs of mental health and substance abuse coverage. Health Affairs. 1995;14:102–115
  14. Galanter M, Keller DS, Dermatis H, Egelko S. Impact on managed care on substance abuse treatment: Report of the American Society of Addiction Medicine. Journal of Addictive Diseases. 2000;19:13–34
  15. Goldman W, McCulloch J, Sturm R. Costs and use of mental health services before and after managed care. Health Affairs. 1998;17:40–52
  16. Grant BF. Barriers to alcoholism treatment: Reasons for not seeking treatment in a general population sample. Journal of Studies on Alcohol. 1997;58:365–371
  17. Greenfield TK, Weisner C. Drinking problems and self-reported criminal behavior, arrests and convictions: 1990 U.S. Alcohol and 1989 County Surveys. Addiction. 1995;90:361–373
  18. Hay Group. Employer health care dollars spent on substance abuse. Chevy Chase, MD: American Society of Addiction Medicine; 1999;
  19. Hilton ME. Drinking patterns and drinking problems in 1984: Results from a general population survey. Alcoholism: Clinical and Experimental Research. 1987;11:167–175
  20. Iglehart JK. Health policy report managed care and mental health. The New England Journal of Medicine. 1996;334:131–135
  21. Kaskutas L, Russell G, Dinis M. Technical report on the alcohol treatment utilization study in public and private sectors. Berkeley, CA: Alcohol Research Group; 1997;
  22. McKusick D, Mark TL, King E, Harwood R, Buck JA, Dilonardo J, et al. Spending for mental health and substance abuse treatment, 1996. Health Affairs. 1998;17:147–157
  23. McLellan TA, Kushner H, Metzger D, Peters R, Smith I, Grissom G, et al. The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment. 1992;9:199–213
  24. Mechanic D, McAlpine D. Mission unfulfilled: Potholes on the road to mental health parity. Health Affairs. 1999;18:7–21
  25. Mechanic D, Schlesinger M, McAlpine D. Management of mental health and substance abuse services: State of the art and early results. The Milbank Quarterly. 1995;73:19–56
  26. Regopoulos L, Trude S. Employers shift rising health care costs to workers: No long-term solution in sight. Washington, DC: Center for Studying Health System Change; 2004;
  27. Rogowski JA. Insurance coverage for drug abuse. Health Affairs. 1992;11:137–148
  28. Rowland D, Hanson K. Medicaid: Moving to managed care. Health Affairs. 1996;15:150–152
  29. Schmidt L. Technical Report: Coding Scheme for Insurance Variables, Study of Treated and Untreated Problem Drinkers, Baseline (PP95) and Wave 1 of Follow-up (Technical Report). Berkeley, CA: Alcohol Research Group; 2001;
  30. Schmidt L, Piroth K, Weisner C. Substance abuse and mental health treatment systems: The changing organization of service delivery and its implications: Report to the National Archive and Analytic Center for Alcohol, Drug Abuse and Mental Health Data. Washington DC: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 1998;
  31. Schoenbaum M, Zhang W, Sturm R. Costs and utilization of substance abuse care in a privately insured population under managed care. Psychiatric Services. 1998;49:1573–1578
  32. Schroeder SA. The medically uninsured - Will they always be with us?. New England Journal of Medicine. 1996;334:1130–1133
  33. Shore MF. In: Managed care, the private sector, and Medicaid mental health and substance abuse services. Vol. 72:San Francisco, CA: Jossey-Bass Publishers; 1996;
  34. Stein B, Orlando M, Sturm R. The effect of copayments on drug and alcohol treatment following inpatient detoxification under managed care. Psychiatric Services. 2000;51:195–198
  35. Sturm R. How does risk sharing between employers and a managed behavioral health organization affect mental health care?. Health Services Research. 2000;35:761–776
  36. Tam T. Technical report on the alcohol treatment utilization study in public and private sectors: Within and across sector weights. Berkeley, CA: Alcohol Research Group; 1997;
  37. Thompson JW, Burns BJ, Goldman HH, Smith J. Initial level of care and clinical status in a managed mental health program. Hospital and Community Psychiatry. 1992;43:599–603
  38. United States Census Bureau. Income, poverty, and health insurance coverage in the United States: 2003. Washington, DC: U.S. Bureau of the Census; 2003;
  39. United States Center for Health Statistics. Health, United States, 1999 (No. PHS 98–1232). Hyattsville, MD: United States Department of Health and Human Services; 1999;
  40. United States General Accounting Office. Drug abuse treatment: Data limitations affect the accuracy of national and state estimates of need (No. HEHS 98-229). Washington, DC: United States General Accounting Office; 1998;
  41. Weisner C. Toward an alcohol treatment entry model: A comparison of problem drinkers in the general population and in treatment. Alcoholism: Clinical and Experimental Research. 1993;17:746–752
  42. Weisner C, Greenfield T, Room R. Trends in the treatment of alcohol problems in the U.S. general population, 1979 Through 1990. American Journal of Public Health. 1995;85:55–60
  43. Weisner C, Matzger H. Missed opportunities in screening for alcohol problems in medical and mental health services. Alcoholism: Clinical & Experimental Research. 2003;27:1132–1141
  44. Weisner C, Matzger H, Kaskutas LA. How important is treatment? One-year outcomes of treated and untreated alcohol-dependent individuals. Addiction. 2003;98:901–911
  45. Weisner C, Matzger H, Tam T, Schmidt LA. Who goes to alcohol and drug treatment? Understanding Utilization within the context of insurance. Journal of Studies on Alcohol. 2002;63:673–682
  46. Weisner CM, Schmidt LA. Gender disparities in treatment for alcohol problems. Journal of the American Medical Association. 1992;268:1872–1876
  47. Weisner CM, Schmidt LA. Alcohol and drug problems among diverse health and social service populations. American Journal of Public Health. 1993;83:824–829
  48. Weisner CM, Schmidt LA. Expanding the frame of health services research in the drug abuse field. Health Services Research. 1995;30:707–726
  49. Weisner CM, Schmidt LA, Tam T. Assessing bias in community-based prevalence estimates: Toward an unduplicated count of problem drinkers and drug users. Addiction. 1995;90:391–406
  50. Wells KB, Manning WG, Duan N, Ware JE. Cost sharing and the demand for ambulatory mental health services (Prepared for the Department of Health and Human Services R-2960-HHS). Santa Monica, CA: Rand Corporation; 1982;
  51. Zuvekas SH, Banthin JS, Selden TM. How would mental health parity affect the marginal price of care?. Health Services Research. 2001;35:1207–1227

PII: S0740-5472(04)00129-1

doi: 10.1016/j.jsat.2004.10.008

Journal of Substance Abuse Treatment
Volume 28, Issue 1 , Pages 67-76 , January 2005

Article Tools

* Image Usage & Resolution