Publications

Do the Benefits of More Intensive Substance Abuse Treatment Offset the Costs?

September 2000

In this analysis, we estimated the relationship between treatment intensity and post-treatment societal costs associated with substance abuse treatment clients. We focused on the impact of length of stay and individual and group counseling sessions on crime-related costs (including criminal justice), health care costs, welfare payments, and client earnings. Societal benefits were measured by the estimated reductions in post-treatment costs and welfare payments or estimated increases in earnings and taxes with each additional day of treatment or hour of counseling. The additional benefits from increasing length of stay or counseling were compared with the additional cost of providing such care. The purpose of the analysis was to identify the value to society of varying the length of stay or hours of counseling for clients who received substance abuse treatment.

Client Area: Federal Government
Expertise Area: Mental Health and Substance Abuse

The Economic Cost of Mental Illness, 1992

May 2000

The aim of this study is to identify and quantify the adverse impacts of mental illness and sum together the magnitude of these consequences using economic values—in dollars. This report estimates the direct economic impact of mental illness for 1992 and for 1995.

Client Area: Federal Government
Expertise Area: Chronic Disease / Cost of Illness, Mental Health and Substance Abuse

Contracting for Public Mental Health Services: Opinions of Managed Behavioral Health Care Organizations

April 2000

This report synthesizes the collective experiences of four managed behavioral health care organizations (MBHOs) that hold public sector managed care carve-out contracts. The views presented are those of representatives of the MBHOs who participated in a daylong focus group meeting.

Client Area: Federal Government
Expertise Area: Medicaid and CHIP, Mental Health and Substance Abuse

School-Based Mental Health Services under Medicaid Managed Care

April 2000

This study sought to learn how schools and providers of school-based mental health services work with Medicaid managed care organizations. To that end, it observed the experiences of several States and local communities in providing for the inclusion of school-based mental health services in managed care contracts. The study also explored options and models for including school-based mental health services within managed care; examined financing and reimbursement issues that might affect the viability and expansion of such services; and assessed alternative ways to maintain and expand school-based mental health services within the managed care environment.

Client Area: Federal Government
Expertise Area: Medicaid and CHIP, Mental Health and Substance Abuse

Using Case Mix Adjustment Methods to Measure the Effectiveness of Substance Abuse Treatment: Three Examples Using Client Employment Outcomes

March 2000

The increasing emphasis on fiscal responsibility and accountability has led the Federal government, States, and managed care entities to increase efforts to identify cost-effective health care providers. This report addresses some of the potential challenges of measuring the effectiveness of substance abuse treatment across providers and highlights the importance of controlling for differences in the characteristics of clients treated by each provider (i.e., provider case mix).

Client Area: Federal Government
Expertise Area: Mental Health and Substance Abuse

Access and Utilization of New Antidepressant and Antipsychotic Medications

January 2000

This report contains the results of a study to identify, document, and assess the factors that affect access to and utilization of new generation antidepressant and antipsychotic medications. Three primary questions guided the assessment: What are the formal policies and procedures implemented by health care payers that affect consumer access to and utilization of psychiatric medications? Are these policies and procedures different for psychiatric medications than for other medication classes? How does the implementation of these policies and procedures affect access to and utilization of these medications? Do policies, procedures, and modes of implementation (regardless of whether they differ for mental health) create barriers to adequate mental health care?

Client Area: Federal Government
Expertise Area: Mental Health and Substance Abuse

The Costs and Benefits of Substance Abuse Treatment: Findings from the National Treatment Improvement Evaluation Study (NTIES)

August 1999

The purpose of this study is to quantify the costs and benefits of alcohol and drug abuse treatment and the resulting economic benefits to society, using data from the National Treatment Improvement Evaluation Study (NTIES). Lewin constructed estimates of treatment costs for each of the modalities and across all modalities. To measure benefits, Lewin used data from NTIES to estimate the crime-related and health care costs associated with substance abusers and the income of substance abusers in the periods before and after treatment. The difference between pre-treatment (baseline) costs and post-treatment (follow-up) costs provides an estimate of the economic impact of substance abuse treatment. This "treatment effect" is viewed as a benefit to the extent that it represents avoided crime-related costs, health-care costs, or welfare payments or increased earnings. In other words, the benefits of treatment are equal to the additional costs that would have been incurred and the additional earnings that would not have been realized in the absence of treatment.

Client Area: Federal Government
Expertise Area: Mental Health and Substance Abuse

Economic Cost of Alcohol and Drug Abuse in the United States, 1992

May 1998

The Lewin Group developed estimates of the costs of drug and alcohol abuse in 1992 for The National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The study estimated the economic cost to society from alcohol and drug abuse at $246 billion in 1992. Alcohol abuse and alcoholism cost an estimated $148 billion, while drug abuse and dependence cost an estimated $98 billion.

Client Area: Federal Government
Expertise Area: Chronic Disease / Cost of Illness, Mental Health and Substance Abuse