What is a behavioral health carve-out plan?

A behavioral health carve-out plan refers to a separate contract specifically designed for managing mental health and substance abuse treatment. This type of arrangement allows an insurer or employer to outsource the management of behavioral health services to a specialized organization. The rationale behind such carve-outs is that behavioral health services can require different expertise and management compared to general medical services due to their unique complexities. By creating a distinct contract, employers can ensure that employees receive tailored and focused care, which can lead to better outcomes for mental health and substance abuse issues.

Including all mental health and substance abuse benefits within a single plan does not represent a carve-out; rather, it indicates integrated benefits under one managing entity. Eliminating mental health benefits entirely contradicts the premise of a carve-out, which is aimed at enhancing care, not removing it. Finally, focusing solely on outpatient treatment would not encompass the full range of behavioral health services, as carve-out plans typically provide comprehensive coverage that may include inpatient services as well. Therefore, characterizing a carve-out plan as a separate contract dedicated to behavioral health management accurately captures its essence and purpose.