As the state of Oregon prepared to place substance abuse treatment for Medicaid clients under managed care to control costs, concerns were raised that placement decisions might be made based upon financial considerations rather than client need. Guidelines were developed based on the placement criteria published by the American Society of Addictions Medicine. This paper documents the impact these criteria had on placement of Medicaid clients into substance abuse treatment under the Oregon Health Plan compared to publicly-funded treatment in Washington, a state that was only beginning to implement the criteria. The findings are summarized from analysis of three data sources: structured interviews with a prospective sample of adults based on the Addiction Severity Index (ASI), administrative data, and qualitative interviews with treatment providers and state officials. Results from the ASI by ASAM level support the validity of placements, at least where there has been sufficient training in application of the criteria, despite anecdotal reports to the contrary. Results suggest greater utilization of both outpatient services, especially intensive outpatient, under the Oregon Health Plan. Treatment providers feel that implementation of the criteria has prompted greater professionalism in the assessment process.
Learning Objectives: Participants will be able to: * recognize similarities and differences between the "OSAM" and ASAM placement criteria * cite factors which led to successful implementation of ASAM criteria in Oregon * describe impact ASAM criteria had on client placement and service utilization
Keywords: Substance Abuse Treatment, Managed Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.