Factors related to Medicaid payment acceptance at outpatient substance abuse treatment programs

Medicaid is associated with multiple factors related to improved substance abuse (SA) treatment access and outcomes. The current economic downturn has seen sharply increased Medicaid enrollment. However, historical problems remain for Medicaid recipients, including difficulty in locating medical providers that accept Medicaid. This presentation reports on factors related to US outpatient SA treatment program facility acceptance of Medicaid. Results are based on secondary analysis of 2003-2006 National Survey of Substance Abuse Treatment Services (N-SSATS) data combined with other publically-available data and state Medicaid policy and usage measures. Pooled cross-sectional analyses including state fixed effects were used to assess relationships between SA treatment program Medicaid acceptance and a variety of factors suggested by health services research and ecological systems theories. Predictors included program-level factors, county-level socio-demographics and treatment program density; state-level population characteristics, governmental composition, SA treatment-related factors, and Medicaid policy and usage. Results indicated that the odds of Medicaid acceptance were significantly higher for: (a) programs that had accreditation or licensure and non-profit/government ownership; (b) counties with lower household income and few SA treatment programs; (c) states with increased general fund spending on Medicaid and policy allowing Medicaid coverage of SA treatment. SA treatment program Medicaid acceptance is related to a variety of program-, county, and state-level factors which may impact the ability of clients most in need to access treatment services. Efforts to improve SA treatment access may be strengthened by encouraging Medicaid acceptance via program accreditation/licensure and state adoption of policy facilitating Medicaid coverage of SA treatment services.