Abstract
We examine how well alcohol and other drug abuse treatment is managed and coordinated in a setting where it is the responsibility of medical plans (a common approach despite the spread of 'carve-outs'). We surveyed a stratified random sample of outpatient alcohol/other drug abuse treatment facilities that treated Michigan Medicaid clients in 1997. Clients were enrolled either with health maintenance organizations (HMOs) or non-capitated primary care gatekeepers. Providers gave medical gatekeepers only average scores for coordination of alcohol and other drug abuse treatment with primary care and with mental health treatment. Few facilities reported ever receiving feedback from HMOs about client satisfaction (29% of facilities) or client outcomes (18%).