216220 Factors related to Medicaid payment acceptance at outpatient substance abuse treatment programs

Tuesday, November 9, 2010 : 10:47 AM - 11:04 AM

Yvonne Terry-McElrath, MSA , Institute for Social Research, University of Michigan, Ann Arbor, MI
Jamie F. Chriqui, PhD, MHS , Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
Duane C. McBride, PhD , Behavioral Science Department, Andrews University, Berrien Springs, MI
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.

Learning Areas:
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Describe the importance of Medicaid for access to substance abuse treatment. 2. Explain how health services research and ecological systems theories aid in understanding environmental factors that impact access to substance abuse treatment. 3. Evaluate the relationships between program-, county-, and state-level factors and substance abuse treatment program Medicaid acceptance

Keywords: Medicaid, Substance Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have been involved in public health research on the causes and correlates of substance abuse, as well as systems and policy analysis of substance abuse treatment, for the past 10 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.