This study explores the differential effect of a managed behavioral health Carve-Out (CO) on outpatient treatment quality
for persons with schizophrenia (SCHZ) alone and co-occurring substance use disorders (SUD) (SCHZ+SUD). We used claims data
from a state Medicaid program and employed a retrospective, quasi-experimental design with logit and difference in difference
formula regression models. The results show the CO was associated with greater changes in treatment quality for the SCHZ population,
compared to the SCHZ+SUD population. Most pronounced across both populations were decrements in receiving the psychosocial
treatments for enrollees in the CO arrangement.
Key words Co-occurring disorders - Schizophrenia - Substance use disorders - Quality of care - Managed care
An earlier version of this analysis was presented on June 24, 2004 at the Co-occurring Conditions Conference sponsored by
NIMH, NIDA, NIAAA, AHRQ, HRSA AND SAMHSA.