|April 18, 2003|
Managed Care Substance Abuse Treatment Facilities
Managed care is an integral and expanding part of the U.S. health care system. One of the strategic goals of the Substance Abuse and Mental Health Services Administration (SAMHSA) is to improve managed care outcomes.1 This report describes substance abuse treatment facilities with and without contracts or other arrangements with managed care organizations as reported to the 2000 National Survey of Substance Abuse Treatment Services (N-SSATS). N-SSATS is an annual survey of all facilities in the United States, both public and private, that provide substance abuse treatment.
Facilities and Clients
The proportion of substance abuse treatment facilities with managed care contracts increased from 42 percent in 1996 to 54 percent in 19992 and remained at this level in 2000. Of the 13,428 substance abuse treatment facilities reporting to the 2000 N-SSATS, approximately 7,250 had a contract or other arrangement with one or more managed care organizations. A total of 1,001,000 clients were reported to be in treatment on October 1, 2000, 53 percent of them in managed care facilities. Each such facility on a typical day had 38 clients compared with 31 clients in facilities without managed care contracts.
In 2000, private non-profit and private for-profit organizations had the highest proportions of facilities with managed care contracts, both at about 56 percent (Figure 1). Between 1996 and 2000, facilities owned by State and local governments increased their proportion of managed care contracts from 26 to 42 percent, facilities owned by tribal governments increased their proportion of managed care contracts from 16 to 27 percent, and facilities owned by the Federal government increased their proportion of managed care contracts from 9 to 23 percent.
Type of Care
Hospital inpatient facilities (70 percent) had the highest percentage of managed care agreements. Fifty-six percent of outpatient facilities and 35 percent of non-hospital residential facilities had managed care agreements. Among facilities offering more than one type of care, 65 percent had managed care agreements.
Type of Treatment
Of those facilities with managed care agreements, 12 percent offered detoxification only, 69 percent offered rehabilitation only, and 19 percent offered both. Among facilities without managed care agreements, 23 percent offered detoxification only, 65 percent offered rehabilitation only, and 12 percent offered both.
Some 50 percent of facilities providing methadone/LAAM treatment had managed care compared with 54 percent of non-methadone facilities.
Managed care facilities reported providing comprehensive substance abuse assessment, comprehensive mental health assessment, family counseling, group therapy, pharmacotherapy, and relapse prevention more frequently than facilities without managed care (Table 1).
Programs for Special Populations
Managed care facilities reported providing programs or groups for special populations more frequently than facilities without managed care (Table 2). The largest differences were in programs for adolescents and for the dually diagnosed.
About two-thirds of both facilities with managed care and facilities without managed care received public funds.
Type of Payment Accepted
Managed care facilities accepted cash or self-payment, Medicare, Medicaid, State-financed health insurance, Federal military insurance, and private health insurance more frequently than facilities without managed care (Figure 2).
2Substance Abuse and Mental Health Services Administration (2001, October 19). The DASIS Report. Growth of Managed Care in Substance Abuse Treatment. Rockville, MD: Author.
This page was last updated on December 30, 2008.