Oral

For better or for worse, financing sources tend to shape the type and amount of services available to people with substance use disorders. This session will focus on how major shifts in the flow of spending for substance abuse treatment over the last 20 years have changed for provider groups. The first presentation will review the spending of major payers from 1986 to 2005, highlighting the shift to predominantly public financing. Details will be provided on the spending declines from private insurance and the limits on treatment benefits. The second presentation will examine the allocation of substance abuse treatment spending among major provider groups and how this changed between 1986 and 2005. Shifts to outpatient treatment and settings of care will be elucidated. The third presenter will review trends in spending and utilization of substance abuse medications as well as the financial context that influences those trends. The fourth presenter will present studies that drill down to underlying trends, discussing the costs of limiting treatment to only detoxification services and the character of hospital stays for those with substance abuse. Finally, the fifth presentation will review projections of substance abuse treatment spending to the year 2014 and discuss how economic challenges and recent legislation like parity may moderate these future trends.

Session Objectives: 1) Evaluate how funding for substance abuse services in the United States drove the availability and types of services from 1986 to 2005. 2) Describe anticipated trends in substance abuse services through 2014.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)