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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.