Public Sector Managed Care: A Comparative Evaluation

This study was a natural experiment that compares access, costs, outcomes, and cost effectiveness in Santa Clara’s managed care system to two counties without substantial managed care characteristics. Baseline and outcome data was collected for randomly selected clients from each county during calendar years 2000 and 2001. Clients were followed for 12 months after admission. Major project goals were to investigate: (1) the relative equity of access to services for special (women and ethnic minority) populations; (2) the relative severity of substance abuse clients upon entry to treatment; (3) the relative costs of treatment per client; (4) relative client satisfaction and outcomes (substance abuse, medical, legal, family/social, employment, and psychiatric); (5) short term and longer term client treatment outcomes; and (6) cost effectiveness of care along the same dimensions. Important sub groups of clients will also be analyzed: (a) substance abusers with and without psychiatric co-morbidity; (b) male and female clients; (c) Caucasian and Latino/Hispanic clients; and (d) Caucasian and all ethnic minority clients.