TY - JOUR
T1 - Admission practices and cost of care for opioid use disorder at residential addiction treatment programs in the us
AU - Beetham, Tamara
AU - Saloner, Brendan
AU - Gaye, Marema
AU - Wakeman, Sarah E.
AU - Frank, Richard G.
AU - Barnett, Michael Lawrence
N1 - Publisher Copyright:
© 2021, Project HOPE. All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - The use of acute, short-term residential care for opioid use disorder has grown rapidly, with policy makers advocating to increase the availability of “treatment beds.” However, there are concerns about high costs and misleading recruitment practices. We conducted an audit survey of 613 residential programs nationally, posing as uninsured cash-paying individuals using heroin and seeking addiction treatment. One-third of callers were offered admission before clinical evaluation, usually within one day. Most programs required up-front payments, with for-profit programs charging more than twice as much (17,434) as nonprofits (s5,712). Recruitment techniques (for example, offering paid transportation) were used frequently by for-profit, but not nonprofit, programs. Practices including admission offers during the call, high up-front payments, and recruitment techniques were common even among programs with third-party accreditation and state licenses. These findings raise concerns that residential programs, including accredited and licensed ones, may be admitting a clinically and financially vulnerable population for costly treatment without assessing appropriateness for other care settings.
AB - The use of acute, short-term residential care for opioid use disorder has grown rapidly, with policy makers advocating to increase the availability of “treatment beds.” However, there are concerns about high costs and misleading recruitment practices. We conducted an audit survey of 613 residential programs nationally, posing as uninsured cash-paying individuals using heroin and seeking addiction treatment. One-third of callers were offered admission before clinical evaluation, usually within one day. Most programs required up-front payments, with for-profit programs charging more than twice as much (17,434) as nonprofits (s5,712). Recruitment techniques (for example, offering paid transportation) were used frequently by for-profit, but not nonprofit, programs. Practices including admission offers during the call, high up-front payments, and recruitment techniques were common even among programs with third-party accreditation and state licenses. These findings raise concerns that residential programs, including accredited and licensed ones, may be admitting a clinically and financially vulnerable population for costly treatment without assessing appropriateness for other care settings.
UR - http://www.scopus.com/inward/record.url?scp=85101259073&partnerID=8YFLogxK
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U2 - 10.1377/hlthaff.2020.00378
DO - 10.1377/hlthaff.2020.00378
M3 - Article
C2 - 33523744
AN - SCOPUS:85101259073
SN - 0278-2715
VL - 40
SP - 317
EP - 325
JO - Health Affairs
JF - Health Affairs
IS - 2
ER -