Some economics of mental health 'carve-outs'

Arch Gen Psychiatry. 1996 Oct;53(10):933-7. doi: 10.1001/archpsyc.1996.01830100081010.

Abstract

We discuss the rationale for benefit carve-out contracts in general and for mental health and substance abuse in particular. We focus on the control of adverse selection as a principal explanation and find that this is consistent with the wide-spread use of sole-source contracting with periodic rebidding. We also find that some degree of risk sharing is common; we interpret this as a method of balancing cost-containment incentives with incentives to maintain access and quality on unmeasured dimensions.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Capitation Fee
  • Competitive Bidding / economics
  • Contract Services / economics*
  • Cost Sharing
  • Health Benefit Plans, Employee / economics
  • Health Benefit Plans, Employee / organization & administration
  • Health Care Costs
  • Health Care Rationing
  • Humans
  • Insurance, Health / economics*
  • Insurance, Psychiatric / economics
  • Managed Care Programs
  • Medicaid / economics
  • Mental Disorders / economics*
  • Mental Disorders / therapy*
  • Risk Assessment
  • Substance-Related Disorders / economics
  • Substance-Related Disorders / therapy
  • United States