The impact of HMO development on mental health and chemical dependency services.

The effects of the development of HMOs on the delivery of mental health and chemical dependency treatment services in Minneapolis-St. Paul were examined through structured interviews with representatives of HMOs and other provider groups. The structure and policies of five competing HMOs are described. Although all five HMOs have reduced their members' use of inpatient mental health and chemical dependency services, use of services by the non-HMO population remains substantially higher than national averages. HMO growth has stimulated the emergence of new types of mental health and chemical dependency treatment organizations to provide services to HMOs and has increased acceptance of goal-oriented, outpatient-based treatment strategies by providers.