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Mental health carve-outs: effects and implications.
Med Care Res Rev. 1999; 56 Suppl 2:37-59.MC

Abstract

To control the rise in expenditures and to increase access to mental health and substance abuse (MH/SA) services, a growing number of employers and states are implementing a "carve-out." Under this arrangement, the sponsor separates insurance benefits by disease or condition, service category, or population and contracts separately for the management of care and/or associated risks. A carve-out allows a unique set of managed care techniques to be applied to a subset of particularly costly or complex benefits. This article describes various carve-out models, discusses the potential advantages and disadvantages of a full carve-out, and summarizes recent public and private sector research regarding the strategy's effects on access and use, cost savings and shifting, and quality of care. It concludes by discussing approaches to the assessment and monitoring of the processes and outcomes associated with a MH/SA carve-out.

Authors+Show Affiliations

Grazier KL
University of Michigan, USA.
Eselius LL
No affiliation info available

MeSH

Contract ServicesCost ControlDisease ManagementEmployer Health CostsHealth Benefit Plans, EmployeeHealth Services AccessibilityHumansManaged Care ProgramsMedicaidMental Health ServicesProduct Line ManagementUnited States

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

10327823

Citation

Grazier, K L., and L L. Eselius. "Mental Health Carve-outs: Effects and Implications." Medical Care Research and Review : MCRR, vol. 56 Suppl 2, 1999, pp. 37-59.
Grazier KL, Eselius LL. Mental health carve-outs: effects and implications. Med Care Res Rev. 1999;56 Suppl 2:37-59.
Grazier, K. L., & Eselius, L. L. (1999). Mental health carve-outs: effects and implications. Medical Care Research and Review : MCRR, 56 Suppl 2, 37-59.
Grazier KL, Eselius LL. Mental Health Carve-outs: Effects and Implications. Med Care Res Rev. 1999;56 Suppl 2:37-59. PubMed PMID: 10327823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mental health carve-outs: effects and implications. AU - Grazier,K L, AU - Eselius,L L, PY - 1999/5/18/pubmed PY - 1999/5/18/medline PY - 1999/5/18/entrez SP - 37 EP - 59 JF - Medical care research and review : MCRR JO - Med Care Res Rev VL - 56 Suppl 2 N2 - To control the rise in expenditures and to increase access to mental health and substance abuse (MH/SA) services, a growing number of employers and states are implementing a "carve-out." Under this arrangement, the sponsor separates insurance benefits by disease or condition, service category, or population and contracts separately for the management of care and/or associated risks. A carve-out allows a unique set of managed care techniques to be applied to a subset of particularly costly or complex benefits. This article describes various carve-out models, discusses the potential advantages and disadvantages of a full carve-out, and summarizes recent public and private sector research regarding the strategy's effects on access and use, cost savings and shifting, and quality of care. It concludes by discussing approaches to the assessment and monitoring of the processes and outcomes associated with a MH/SA carve-out. SN - 1077-5587 UR - https://www.unboundmedicine.com/medline/citation/10327823/Mental_health_carve_outs:_effects_and_implications_ L2 - https://medlineplus.gov/managedcare.html DB - PRIME DP - Unbound Medicine ER -