Relationship between facility ownership, service to Medicaid patients and types of treatment services offered

Background: The substance abuse treatment literature has documented the role that program ownership plays in service offerings. Little is known about which ownership type may relate to the services that are offered at programs serving Medicaid clients. The purpose of this study is to examine the relationship between ownership type (government, private non-profit and private for profit) and treatment program practices for programs serving Medicaid clients.

Methods: Data on treatment program practices and program ownership were obtained from the 2000-20005 National Survey of Substance Abuse Treatment Services (N-SSATS; N=22,646 programs). Multivariate logistic and ordinary least square regression models were used to estimate the relationships.

Results: Preliminary data analyses indicate that non-profit outpatient treatment programs are significantly more likely to treat Medicaid clients than are for-profit and government-owned programs (×2=2204, p<.001). As compared to for-profit-owned programs, non-profit and government-owned programs serving Medicaid clients were significantly more likely to include infectious disease related testing, transitional and ancillary services, and maintenance/relapse prevention services (all p<.001).

Implications: These data indicate that program ownership may play a pivotal role in affecting the types of clients served and the types of services that are offered to clients. Given debates about the role of privatization of substance abuse treatment services, the data suggest that public ownership and non-profit ownership are significantly more likely to serve Medicaid clients and offer broader public health services as well as comprehensive treatment services related to improved outcomes. These findings have major implications for public health policy and substance abuse treatment services.