Services for Substance Abusers in a Changing Health Care System

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Abstract
Many managed care plans may need to modify their coverage to address substance abusers' multidimensional physical, mental, and social problems. Such adjustments are particularly important for public sector clients whose addiction-related problems are typically more severe than those of private sector patients. Data from a sample of 161 medical emergency, primary care, mental health, and substance abuse treatment programs in Dade County, Florida, reveal highly varied perceptions of managed care. They illustrate that the relevance of provider organization ownership, type of services, and populations served for behavioral managed care analysis. Further implications are the need to provide “wrap-around” or enabling services and to coordinate care for substance abusers to avoid displacement of responsibility for critical aspects of their care onto overwhelmed “safety net” agencies.