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
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Research Support, U.S. Gov't, Non-P.H.S.
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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Capitation Fee
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Competitive Bidding / economics
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Contract Services / economics*
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Cost Sharing
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Health Benefit Plans, Employee / economics
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Health Benefit Plans, Employee / organization & administration
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Health Care Costs
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Health Care Rationing
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Humans
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Insurance, Health / economics*
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Insurance, Psychiatric / economics
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Managed Care Programs
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Medicaid / economics
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Mental Disorders / economics*
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Mental Disorders / therapy*
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Risk Assessment
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Substance-Related Disorders / economics
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Substance-Related Disorders / therapy
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United States