Factors Related to Medicaid Payment Acceptance at Outpatient Substance Abuse Treatment Programs

Terry‐McElrath, Yvonne M.; Chriqui, Jamie F.; McBride, Duane C.

doi:10.1111/j.1475-6773.2010.01206.x

Cited by 16 publications

(24 citation statements)

References 22 publications

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“…Accepting Medicaid may well be a part of an overall organizational commitment, regardless of type of ownership, to offering a wide range of evidence-based services that include ancillary and transitional services. Importantly, research indicates that only about half of states allowed Medicaid to pay for outpatient SAT services as part of Medicaid benefit offerings (Terry-McElrath et al, 2011). The data presented in this article suggest that state implementation of Medicaid policies allowing payment for SAT services may play a major role in improving the quality of treatment through facilitating core ancillary/transitional services and improving access for vulnerable populations.…”

Section: Discussionmentioning

confidence: 91%

Drug treatment program ownership, Medicaid acceptance, and service provision

McBride

Chriqui

Terry‐McElrath

et al. 2012

Journal of Substance Abuse Treatment

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The Institute of Medicine noted that effective substance abuse treatment (SAT) programs integrate individual therapeutic approaches with transitional/ancillary services. In addition, research suggests that type of ownership impacts SAT services offered and that Medicaid plays a key role in SAT access. Data from the National Survey of Substance Abuse Treatment Services for the years 2000 and 2002-2006 were used to examine relationships among SAT program Medicaid acceptance, program ownership, and transitional/ancillary service accessibility. Multivariate logistic regression models controlling for state- and program-level contextual factors were used to analyze the data. Nonprofit SAT programs were significantly more likely to offer transitional/ancillary services than for-profit programs. However, programs that accepted Medicaid, regardless of ownership, were significantly more likely to offer most transitional/ancillary services. The data suggest that Medicaid may play a significant role in offering key transitional/ancillary services related to successful treatment outcome, regardless of program ownership type.

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Section: Discussionmentioning

confidence: 91%

Drug treatment program ownership, Medicaid acceptance, and service provision

McBride

Chriqui

Terry‐McElrath

et al. 2012

Journal of Substance Abuse Treatment

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“…1 with a solid line: federal funding influence and state SA priority. State SA priority is defined as capacities to deliver services and legislative or bureaucratic support of SA treatment [29][30][31]. The framework also accounts for the three other institutional constraints in Hernandez & Uggen, represented by dashed lines.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…A recent study examining the activation of state MH parity laws over 25 years found four significant predictors of activation: economic climate, political party control, presence of a strong advocacy group and interstate influences [28]. Other studies have examined the role of state-level institutional constraints for BH policy and are used to identify empirically testable institutional constraints: increasing treatment providers' use of psychotropic medications [29]; the acceptance of Medicaid funding at out-patient treatment centers [30]; and the differential provision of services between publicly and privately financed treatment providers [31]. We use constraints from these four papers to examine the activation decision empirically.…”

Section: Introductionmentioning

confidence: 99%

The influence of state‐level policy environments on the activation of the Medicaid SBIRT reimbursement codes

et al. 2017

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Aims To examine how institutional constraints, comprising federal actions and states' substance abuse policy environments, influence states' decisions to activate Medicaid reimbursement codes for screening and brief intervention for risky substance use in the United States. Methods A discrete-time duration model was used to estimate the effect of institutional constraints on the likelihood of activating the Medicaid reimbursement codes. Primary constraints included federal Screening, Brief Intervention and Referral to Treatment (SBIRT) grant funding, substance abuse priority, economic climate, political climate and interstate diffusion. Study data came from publicly available secondary data sources. Results Federal SBIRT grant funding did not affect significantly the likelihood of activation (P = 0.628). A $1 increase in per-capita block grant funding was associated with a 10-percentage point reduction in the likelihood of activation (P = 0.003) and a $1 increase in per-capita state substance use disorder expenditures was associated with a 2-percentage point increase in the likelihood of activation (P = 0.004). States with enacted parity laws (P = 0.016) and a Democratic-controlled state government were also more likely to activate the codes. Conclusion In the United States, the determinants of state activation of Medicaid Screening, Brief Intervention and Referral to Treatment (SBIRT) reimbursement codes are complex, and include more than financial considerations. Federal block grant funding is a strong disincentive to activating the SBIRT reimbursement codes, while more direct federal SBIRT grant funding has no detectable effects.

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“…It is important to note that Medicaid itself has historically been implemented differently across states in terms of which treatment services are covered (Garfield et al, 2010; Terry-McElrath et al, 2011). There has been a tendency within the SUD treatment field to regard Medicaid policies as a hindrance to innovation adoption, a perspective not supported by these data.…”

Section: Discussionmentioning

confidence: 99%

“…Collection of Medicaid policy data was beyond the scope of the current study, so we were unable to control for whether programs were located in states where Medicaid provided coverage for MAT and included these medications on its formulary. Resource dependence theory suggests that supportive state policies would likely result in greater implementation of MAT (Kubiak et al, 2009; Thomas et al, 2011), although the presence of a supportive state policy is no guarantee that programs will accept Medicaid payment (Terry-McElrath et al, 2011). …”

Section: Discussionmentioning

confidence: 99%

Financial Factors and the Implementation of Medications for Treating Opioid Use Disorders

Knudsen

Roman

2012

Journal of Addiction Medicine

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Objectives Despite the established effectiveness of pharmacotherapies for treating opioid use disorders, implementation of medications for addiction treatment (MAT) by specialty treatment programs is limited. This research examined relationships between organizational factors and the program-level implementation of MAT, with attention paid to specific sources of funding, organizational structure, and workforce resources. Methods Face-to-face structured interviews were conducted in 2008-2009 with administrators of 154 community-based treatment programs affiliated with the National Institute on Drug Abuse’s Clinical Trials Network (CTN); none of these programs exclusively dispensed methadone without offering other levels of care. Implementation of MAT was measured by summing the percentages of opioid patients receiving buprenorphine maintenance, methadone maintenance, and tablet naltrexone. Financial factors included the percentages of revenues received from Medicaid, private insurance, criminal justice, the Federal block grant, state government, and county government. Organizational structure and workforce characteristics were also measured. Results Implementation of MAT for opioid use disorders was low. Greater reliance on Medicaid was positively associated with implementation after controlling for organizational structure and workforce measures, while the association for reliance on criminal justice revenues was negative. Conclusions The implementation of MAT for opioid use disorders by specialty addiction treatment programs may be facilitated by Medicaid, but may be impeded by reliance on funding from the criminal justice system. These findings point to the need for additional research that considers the impact of organizational dependence on different types of funding on patterns of addiction treatment practice.

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Factors Related to Medicaid Payment Acceptance at Outpatient Substance Abuse Treatment Programs

Abstract: Objective. To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. Data Sources.

Cited by 16 publications

References 22 publications

Drug treatment program ownership, Medicaid acceptance, and service provision

Drug treatment program ownership, Medicaid acceptance, and service provision

The influence of state‐level policy environments on the activation of the Medicaid SBIRT reimbursement codes

Financial Factors and the Implementation of Medications for Treating Opioid Use Disorders

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