Medicaid care management: Description of high-cost addictions treatment clients

被引：11

作者：

Neighbors, Charles J. ^{[1
]}

Sun, Yi ^{[2
,3
]}

Yerneni, Rajeev ^{[1
]}

Tesiny, Ed ^{[2
]}

Burke, Constance ^{[2
]}

Bardsley, Leland ^{[1
]}

McDonald, Rebecca ^{[1
]}

Morgenstern, Jon ^{[1
]}

机构：

[1] Columbia Univ, Hlth & Treatment Res & Anal Div, Natl Ctr Addict & Subst Abuse CASA, New York, NY 10017 USA

[2] New York State Off Alcoholism & Subst Abuse Serv, Div Outcome Management & Syst Investment, Albany, NY 12203 USA

[3] Res Fdn Mental Hyg Inc RFMH, Menands, NY 12204 USA

来源：

JOURNAL OF SUBSTANCE ABUSE TREATMENT | 2013年 / 45卷 / 03期

关键词：

Medicaid; Care management; Costs; Addictions treatment; Healthcare reform; HEALTH-CARE; DISEASE MANAGEMENT; RISK; ASSOCIATION; ASSISTANCE;

D O I：

10.1016/j.jsat.2013.02.009

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

High utilizers of alcohol and other drug treatment (AODTx) services are a priority for healthcare cost control. We examine characteristics of Medicaid-funded AODTx clients, comparing three groups: individuals < 90th percentile of AODTx expenditures (n = 41,054); high-cost clients in the top decile of AODTx expenditures (HC; n = 5,718); and 1760 enrollees in a chronic care management (CM) program for HC clients implemented in 22 counties in New York State. Medicaid and state AODTx registry databases were combined to draw demographic, clinical, social needs and treatment history data. HC clients accounted for 49% of AODTx costs funded by Medicaid. As expected, HC clients had significant social welfare needs, comorbid medical and psychiatric conditions, and use of inpatient services. The CM program was successful in enrolling some high-needs, high-cost clients but faced barriers to reaching the most costly and disengaged individuals. (C) 2013 Elsevier Inc. All rights reserved.

引用

页码：280 / 286

页数：7

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