Episodes of mental health and substance abuse treatment under a managed behavioral health care carve-out.

Little is known about the effect of a managed behavioral health care (MBHC) carve-out on treatment episodes for a mental health/substance abuse (MHSA) condition. This study found adoption of a carve-out for Massachusetts state employees associated with a dramatic drop in total MHSA costs per episode (particularly for individuals with certain severe MHSA conditions). The carve-out also was associated with a shift away from the use of facility care toward the use of outpatient care for enrollees with a diagnosis of unipolar depression.