Abstract
Understanding the cost of resources used in substance abuse treatment is of critical concern to policymakers, payers, and providers of care. Federal and State policymakers are interested in cost-effective allocation of limited funds and in developing efficient financing
structures to deliver substance abuse treatment services. State agencies, Medicaid, and managed behavioral health organizations allocate resources among types of care. Substance abuse treatment organizations are oriented toward producing services efficiently, setting appropriate charge rates, and negotiating contracts with managed care organizations. Each of these decision makers can use improved information about the costs of substance abuse treatment to better serve patients receiving treatment.
The Alcohol and Drug Services Study (ADSS) was performed from 1996 to 1999. ADSS is a national study conducted in three phases to collect representative data on the characteristics of substance abuse treatment facilities, clients in treatment, post-treatment client status, and financing of care in the specialty substance abuse treatment sector. This sector includes freestanding substance abuse treatment centers, methadone maintenance clinics, and other facilities that primarily serve persons with substance abuse problems.
Phase I of ADSS surveyed a nationally representative set of 2,395 treatment facilities by telephone. Phase II conducted in-person interviews with administrators regarding revenues, costs, and staffing, and it analyzed a client record abstraction at a subset of 280 facilities. Phase III conducted follow-up interviews with a sample of clients for whom records were abstracted. ADSS data are an important aid in understanding the organization of treatment, cost and availability of treatment services, characteristics of the client population, and managed care contract arrangements.
The purpose of the ADSS cost study was to provide a detailed data file and national estimates for cost, revenue, counseling activities, and staffing collected from a nationally representative sample of substance abuse treatment facilities. A new, more accurate cost collection strategy was developed for this study and is described in the following steps.