Medicare, Medicaid, and Managed Care Analysis
The financing of mental health and substance abuse (MH/SA) treatment has changed dramatically
in the past decade as a result of increases in the cost of MH/SA treatment. In response
to these changes and the need to better understand their implications for MH/SA treatment,
the Substance Abuse and Mental Health Services Administration's (SAMHSA's) Center
for Mental Health Services (CMHS) authorized the first Medicare, Medicaid, and Managed
Care Analysis (MMMCA) project in 1995. RTI International and its subcontractors-Medstat,
Brandeis University, and New England Research Institutes-have held the contract since
its inception.
The main objective of the MMMCA project is to create a longitudinal database of persons
with MH/SA disorders (identified through diagnoses, procedures, or services) by building
on existing data files. These existing files include Medicare and Medicaid public
sector data, as well as MarketScan® private sector data. Because the quality of public
sector managed care data has been limited, public sector analysis is restricted to
fee-for-service (FFS) data. Private sector analysis includes both FFS and managed
care data.
The primary product of the MMMCA project is a set of analytic tables which present
detailed estimates of MH/SA prevalence, service utilization, and payments for each
data source. Additional products include technical assistance to researchers and reports
which are disseminated through government publications, peer-reviewed journals, presentations
at national conferences, and project reports.
The MMMCA project currently is funded by SAMHSA/CMHS Task Order No. 280.2003.00026.0001.
Dr. Ronald Manderscheid of CMHS is the task order officer. Additional funding comes
from SAMHSA's Center for Substance Abuse Treatment.