Monitoring change in behavioral health care. The role of the Center for Mental Health Services.

One of the strategic goals of the Substance Abuse and Mental Health Services Administration (SAMHSA) is to improve managed care outcomes. This report from the Office of Managed Care, Center for Mental Health Services, summarizes the results of six SAMHSA projects. The studies discussed were selected because they have yielded substantive findings. One nationwide evaluation showed increasing complexity in contracts between state Medicaid agencies and managed care organizations, as states move toward greater use of managed mental health and substance abuse program arrangements and greater inclusion of persons with disabilities. A report from SAMHSA's Managed Care Tracking System indicates that, contrary to predictions, most public-sector mental health and substance abuse programs are managed by public-sector agencies or public or private partnerships rather than by private managed care organizations. Also, an analysis of pre-managed care Medicaid data on mental health and substance abuse services in 10 states is serving as a baseline to assess the effects of managed care on Medicaid mental health and substance abuse program use and costs.