Factors Related to Medicaid Payment Acceptance at Outpatient Substance Abuse Treatment Programs
Yvonne M. Terry-McElrath
Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248
Address correspondence to Yvonne M. Terry-McElrath, M.S.A., Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248; e-mail: [email protected]. Jamie F. Chriqui, Ph.D., M.H.S., is with the Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL. Duane C. McBride, Ph.D., is with the Behavioral Sciences Department, Institute for Prevention of Addictions, Andrews University, Berrien Springs, MI.
Search for more papers by this authorJamie F. Chriqui
Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248
Search for more papers by this authorDuane C. McBride
Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248
Search for more papers by this authorYvonne M. Terry-McElrath
Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248
Address correspondence to Yvonne M. Terry-McElrath, M.S.A., Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248; e-mail: [email protected]. Jamie F. Chriqui, Ph.D., M.H.S., is with the Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL. Duane C. McBride, Ph.D., is with the Behavioral Sciences Department, Institute for Prevention of Addictions, Andrews University, Berrien Springs, MI.
Search for more papers by this authorJamie F. Chriqui
Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248
Search for more papers by this authorDuane C. McBride
Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248
Search for more papers by this authorAbstract
Objective. To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs.
Data Sources. Secondary analysis of 2003–2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly available data.
Study Design. We used cross-sectional analyses, including state fixed effects, to assess relationships between SA treatment program Medicaid acceptance and (1) program-level factors, (2) county-level sociodemographics and treatment program density, and (3) state-level population characteristics, SA treatment-related factors, and Medicaid policy and usage.
Data Extraction Methods. State Medicaid policy data were compiled based on reviews of state Medicaid-related statutes/regulations and Medicaid plans. Other data were publicly available.
Principal Findings. Medicaid acceptance was significantly higher for programs: (a) that were publicly funded and in states with Medicaid policy allowing SA treatment coverage; (b) with accreditation/licensure and nonprofit/government ownership, as well as mental- and general-health focused programs; and (c) in counties with lower household income.
Conclusions. SA treatment program Medicaid acceptance related to program-, county, and state-level factors. The data suggest the importance of state policy and licensure/accreditation requirements in increasing SA program Medicaid access.
Supporting Information
Appendix SA1: Author Matrix.
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REFERENCES
- Aday, L. A., C. E. Begley, D. R. Lairson, and R. Balkrishnan. 2004. Evaluating the Healthcare System: Effectiveness, Efficiency, and Equity. 3rd Edition. Chicago, IL: Health Administration Press.
- Blondell, R. D., A. Amadasu, T. J. Servoss, and S. J. Smith. 2006. “Differences among Those Who Complete and Fail to Complete Inpatient Detoxification. Journal of Addictive Diseases 25 (1): 95–104.
-
Carise, D.,
A. T. McLellan,
D. S. Festinger, and H. D. Kleber. 2005. “Identifying United States Substance Abuse Treatment Programs: A Test in One Mid-Sized City.
Substance Abuse
25: 21–8.
10.1300/J465v25n02_04 Google Scholar
- Centers for Medicare and Medicaid Services. 2005. Medicaid At-a-Glance, 2005. Baltimore, MD: Department of Health and Human Services, Centers for Medicare and Medicaid Services, Center for Medicaid and State Operations [accessed on January 16, 2010]. Available at http://www.cms.hhs.gov/MedicaidGenInfo/Downloads/MedicaidAtAGlance2005.pdf
- Chriqui, J. F., Y. M. Terry-McElrath, D. C. McBride, and S. S. Edison. 2008. “State Policies Matter: The Case of Outpatient Drug Treatment Program Practices. Journal of Substance Abuse Treatment 35: 13–21.
- Chriqui, J. F., Y. M. Terry-McElrath, D. C. McBride, S. S. Edison, and C. J. VanderWaal. 2007. “Does State Certification or Licensure Influence Outpatient Substance Abuse Treatment Programs? Journal of Behavioral Health Services and Research 34 (3): 309–28.
- Clark, R. E., M. Samnaliev, and M. P. McGovern. 2009. “Impact of Substance Disorders on Medical Expenditures for Medicaid Beneficiaries with Behavioral Health Disorders. Psychiatric Services 60 (1): 35–42.
- Cunningham, P. J. 2002. Mounting Pressures: Physicians Serving Medicaid Patients and the Uninsured, 1997–2001. Tracking Report No. 6. Washington, DC: Center for Studying Health System Change.
- Cunningham, P. J., and J. May. 2006. Medicaid Patients Increasingly Concentrated among Physicians. Tracking Report No. 16. Washington, DC: Center for Studying Health System Change.
- Cunningham, P. J., and L. M. Nichols. 2005. “Effects of Medicaid Reimbursement on the Access to Care of Medicaid Enrollees: A Community Perspective. Medical Care Research and Review 62 (6): 676–96.
- Deck, D. D., and R. M. Gabriel. In press. “ Impact of Eliminating Medicaid Treatment Benefits.” In Medicaid and Treatment for People with Substance Abuse Problems, edited by B. H. McFarland, D. McCarty, and A. E. Kovas. Hauppauge, NY: Nova Science Publishers.
- Deck, D. D., W. L. Wiitala, and K. E. Laws. 2006. “Medicaid Coverage and Access to Publicly Funded Opiate Treatment. Journal of Behavioral Health Services and Research 33 (3): 324–34.
- Ducharme, L. J., and A. J. Abraham. 2008. “State Policy Influence on the Early Diffusion of Buprenorphine in Community Treatment Programs. Substance Abuse Treatment, Prevention, and Policy 3 (17): 1–10.
- Fleming, M. F., M. P. Mundt, M. T. French, L. B. Manwell, E. A. Stauffacher, and K. L. Barry. 2002. “Brief Physician Advice for Problem Drinkers: Long-Term Efficacy and Benefit-Cost Analysis. Alcoholism: Clinical and Experimental Research 26 (1): 36–43.
- Friedmann, P. D., S. C. Lemon, M. D. Stein, and T. A. D'Aunno. 2003. “Accessibility of Addiction Treatment: Results from a National Survey of Outpatient Substance Abuse Treatment Organizations. Health Services Research 38 (3): 887–903.
- Harrow, B. S., C. P. Tompkins, P. D. Mitchell, K. W. Smith, S. Soldz, L. Kasten, and K. Fleming. 2006. “The Impact of Publicly Funded Managed Care on Adolescent Substance Abuse Treatment Outcomes. American Journal of Drug and Alcohol Abuse 32 (3): 379–98.
- Heinrich, C. J., and C. J. Hill. 2008. “Role of State Policies in the Adoption of Naltrexone for Substance Abuse Treatment. Health Services Research 43 (3): 951–70.
- Holahan, J., and I. Headen. 2010. Medicaid Coverage and Spending in Health Reform: National and State-by-State Results for Adults at or Below 133% FPL, Executive Summary (Report No. 8076-ES). Washington, DC: Kaiser Family Foundation, Kaiser Commission on Medicaid and the Uninsured [accessed on August 16, 2010]. Available at http://www.kff.org/healthreform/upload/Medicaid-Coverage-and-Spending-in-Health-Reform-National-and-State-By-State-Results-for-Adults-at-or-Below-133-FPL-Executive-Summary.pdf
- Jacobs, S. C., J. E. Wilk, and M. Rubio-Stipec. 2005. “Psychiatrists' Acceptance of Medicaid Patients. Psychiatric Services 56 (11): 1461.
- Levit, K. R., C. A. Kassed, R. M. Coffey, T. L. Mark, E. M. Stranges, J. A. Buck, and R. Vandivort-Warren. 2008. “Future Funding for Mental Health and Substance Abuse: Increasing Burdens for the Public Sector. Health Affairs (Millwood) 27 (6): w518–22.
- Mark, T. L., K. R. Levit, R. Vandivort-Warren, R. M. Coffey, J. A. Buck, and SAMHSA Estimates Spending Team. 2007. “Trends in Spending for Substance Abuse Treatment, 1986–2003. Health Affairs 26 (4): 1118–28.
- McBride, D., J. Chriqui, M. Mulatu, and Y. Terry-McElrath. 2008. The Role of Medicaid in Service Provision and Access to Services for African Americans. Paper presented at the 2008 Substance Abuse Policy Research Annual Grantee Meeting, Tucson, AZ, December 15–16.
- McLellan, A. T., D. C. Lewis, C. P. O'Brien, and H. D. Kleber. 2000. “Drug Dependence, a Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation. Journal of the American Medical Association 284 (13): 1689–95.
- Medical News Today. 2008. “States See Higher Medicaid Enrollment as Economic Downturn Persists, Study Finds” [accessed on January 16, 2010]. Available at http://www.medicalnewstoday.com/articles/123665.php
- Nahra, T. A., J. Alexander, and H. Pollack. 2009. “Influence of Ownership on Access in Outpatient Substance Abuse Treatment. Journal of Substance Abuse Treatment 36 (4): 355–65.
- J. L. Nolan (ed). 2002. Drug Courts in Theory and in Practice. New York: Walter de Gruyter, Inc.
- Office of National Drug Control Policy. 2010. National Drug Control Strategy: A New Balanced Approach, Highlights. Washington, DC: ONDCP [accessed on August 16, 2010]. Available at http://www.whitehousedrugpolicy.gov/strategy/highlight_brochure.pdf
- Perloff, J. D., P. Kletke, and J. W. Fossett. 1995. “Which Physicians Limit Their Medicaid Participation, and Why. Health Services Research 31 (1): 7–26.
- Sack, K., and K. Zezima. 2009. “Growing Need for Medicaid Strains States.”New York Times, January 21: A25 [accessed on January 15, 2010]. Available at http://www.nytimes.com/2009/01/22/us/22medicaid.html?_r=4andref=todayspaper
- Shen, Y.-C., and S. Zuckerman. 2005. “The Effect of Medicaid Payment Generosity on Access and Use among Beneficiaries. Health Services Research 40 (3): 723–44.
- U.S. Department of Health and Human Services (USDHHS). 2005. National Survey of Substance Abuse Treatment Services (N-SSATS): 2004. Data on Substance Abuse Treatment Facilities. DASIS Series: S-28, DHHS Publication No. (SMA) 05-4112. Rockville, MD: USDHHS, SAMHSA, OAS.
- U.S. Department of Health and Human Services (USDHHS). 2007. National Survey of Substance Abuse Treatment Services, 2002 through 2006. Princeton, NJ: Mathematica Policy Research Inc. [accessed on January 7, 2009]. Available at http://webapp.icpsr.umich.edu/cocoon/SAMHDA-SERIES/00058.xml
- U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. 2009. National Survey of Substance Abuse Treatment Services (N-SSATS), 2007 [United States] [Computer file]. ICPSR23540-v1. Ann Arbor, MI: Inter-University Consortium for Political and Social Research [distributor], January 2007, doi:DOI: 10.3886/ICPSR23540.
- Wakeman, S. E., M. E. McKinney, and J. D. Rich. 2009. “Filling the Gap: The Importance of Medicaid Continuity for Former Inmates. Journal of General Internal Medicine 24 (7): 860–2.
- Walter, L. J., S. Parthasarathy, S. Allen, and L. Ackerson. 2002. “Medicaid Patients in a Private Health Maintenance Organization: Patterns of Chemical Dependency Treatment. Journal of Behavioral Health Services and Research 29 (1): 1–14.
- Wilk, J. E., J. C. West, W. E. Narrow, D. W. Rae, and D. A. Regier. 2005. “Access to Psychiatrists in the Public Sector and in Managed Health Plans. Psychiatric Services 56 (4): 408–10.
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