Addiction Treatment Suffers Under Managed Care

Conference and report on addiction treatment in managed care

In 1999–2000, staff at the American Society of Addiction Medicine, Chevy Chase, Md., developed a consensus regarding quality addiction treatment in managed care settings and translated that consensus into treatment and policy recommendations.

The society is a professional society dedicated to educating physicians and improving the treatment of people suffering from alcoholism and other addictions.

Key Results

  • Project staff wrote a report with recommendations for addiction treatment in managed care, basing conclusions on several studies and a survey of American Society of Addiction Medicine members. The report made the following conclusions:
    • Addiction disorders are among the most frequently occurring mental health problems in the United States and cost $246 billion per year.
    • The value of addiction treatment benefits for employees of midsize to large-size companies decreased by 74.5 percent from 1988 to 1998 compared with a decrease of 52.3 percent for mental health benefits and 11.5 percent for general health benefits, according to a study commissioned by the American Society of Addiction Medicine and conducted by the Hay Group, a health insurance analysis organization.
    • A shift toward managed care has been associated with a drastic reduction in frequency and duration of inpatient hospitalization, even for many patients who require such hospitalization. It is not clear that that decrease has been offset by an increase in outpatient treatment.
    • The federal Employee Retirement Income Security Act (ERISA) specifies that providers rather than insurers are liable for constraints of treatment. Nonetheless, clinical care decision-making about substance abuse treatment has shifted in large part from providers to the insurance industry.


The Robert Wood Johnson Foundation (RWJF) provided a $50,000 grant in partial support of this project between February 1999 and December 2000.

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