Alternative payment models and alcohol use disorder treatment and consequences

替代支付模式和酒精使用障碍治疗及后果

基本信息

  • 批准号:
    10464490
  • 负责人:
  • 金额:
    $ 63.7万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2022
  • 资助国家:
    美国
  • 起止时间:
    2022-06-10 至 2026-05-31
  • 项目状态:
    未结题

项目摘要

PROJECT SUMMARY Alcohol Use Disorder (AUD) is one of the leading causes of preventable death in the US and has high personal and societal costs. Despite the widespread acceptance that evidence-based treatments exist for AUD, less than one in nine individuals with AUD report receiving specialty treatment. Challenges are particularly acute in disadvantaged communities. Only 60 percent of US counties have a specialty substance use disorder (SUD) treatment clinic that accepts Medicaid, despite Medicaid being the largest payer of addiction treatment services in the US. In 2017, The Centers for Medicare and Medicaid Services initiated the Certified Community Behavioral Health Clinic (CCBHC) demonstration, a program designed to increase access and the receipt of evidence-based care in Medicaid in eight states. As a part of this initiative, CCBHCs were required to provide nine services chosen to improve access; to provide data on quality metrics; and to engage in a prospective payment system. Since the initial 66-clinic demonstration, the CCBHC program has expanded to over 240 clinics in 40 states; A primary distinction between the initial demonstration and the expanded model is that in the expanded model clinics retain traditional reimbursement mechanisms but are awarded a large annual grant (~$2 million). We use a quasi-experimental approach to compare changes in the receipt of AUD services before and after CCBHC program implementation with changes in the receipt of AUD services in a set of matched comparison clinics (or counties). Our project brings together an interdisciplinary team of health services researchers, physicians, and economists with the methodological and substantive expertise to examine this understudied issue and explore its complex public health, clinical, and policy implications. Our specific aims are to assess whether CCBHC implementation was associated with: 1a) Changes in AUD identification and treatment quality; 1b) Differential changes in AUD identification and treatment quality in demonstration versus expansion clinics; 2) Differential changes in AUD treatment receipt and quality during the COVID-19 public health emergency in CCBHC compared to non-CCBHC clinics; and 3) Changes in trajectories of public health outcomes, including county-level reports of crime and alcohol-involved fatal motor vehicle accidents. This grant is responsive to NOT-AA-20-022, “Notice of Special Interest: Advances in Research for the Treatment, Services, and Recovery of Alcohol Use Disorder” and will provide information ‘to bridge the gap between those who need treatment and those who receive treatment.’ In addition, we focus on the Medicaid program, which disproportionately serves NIH-designated US health disparity populations. The significance of this study lies in its focus on how to optimize delivery systems to improve treatment and outcomes associated with AUD, a growing challenge and understudied policy issue.
项目概要 酒精使用障碍 (AUD) 是美国可预防死亡的主要原因之一,并且对个人影响很大 和社会成本。尽管人们普遍认为 AUD 存在基于证据的治疗方法,但较少 超过九分之一的 AUD 患者报告正在接受特殊治疗。挑战尤其严峻 弱势社区。美国只有 60% 的县患有特殊物质使用障碍 (SUD) 尽管医疗补助是成瘾治疗服务的最大支付者,但接受医疗补助的治疗诊所 在美国。 2017 年,医疗保险和医疗补助服务中心发起了认证社区 行为健康诊所 (CCBHC) 示范,这是一个旨在增加访问和接收的计划 八个州医疗补助中的循证护理。作为该举措的一部分,CCBHC 需要提供 选择九项服务来改善准入;提供质量指标数据;并从事前瞻性的 支付系统。自最初的 66 家诊所示范以来,CCBHC 计划已扩展到 240 多家 40 个州的诊所;初始演示和扩展模型之间的主要区别在于 扩大后的示范诊所保留了传统的报销机制,但每年获得大笔补助金 (约 200 万美元)。我们使用准实验方法来比较澳元服务接收的变化 CCBHC 计划实施前后,一组 AUD 服务接收情况发生变化 匹配的比较诊所(或县)。我们的项目汇集了一支跨学科的健康团队 为研究人员、医生和经济学家提供方法论和实质性专业知识服务 研究这个尚未得到充分研究的问题,并探讨其复杂的公共卫生、临床和政策影响。我们的 具体目标是评估 CCBHC 的实施是否与以下因素相关: 1a) 澳元的变化 识别和治疗质量; 1b) AUD 识别和治疗质量的差异变化 示范诊所与扩展诊所; 2)AUD治疗接收和质量的差异变化 与非 CCBHC 诊所相比,CCBHC 的 COVID-19 突发公共卫生事件; 3) 变化 公共卫生结果的轨迹,包括县级犯罪和酒精相关致命运动的报告 车辆事故。这笔赠款是对 NOT-AA-20-022“特别关注的通知:进展 酒精使用障碍的治疗、服务和康复研究”并将提供 信息“以弥合需要治疗的人和接受治疗的人之间的差距。” 此外,我们重点关注医疗补助计划,该计划不成比例地服务于 NIH 指定的美国医疗保健 人口差距。本研究的意义在于关注如何优化递送系统 改善与 AUD 相关的治疗和结果,这是一个日益严峻的挑战,也是未被充分研究的政策问题。

项目成果

期刊论文数量(0)
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Susan H Busch其他文献

Access to treatment before and after Medicare coverage of opioid treatment programs
在医疗保险承保阿片类药物治疗计划之前和之后获得治疗
  • DOI:
  • 发表时间:
    2024
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Ruijie Liu;Tamara Beetham;Helen Newton;Susan H Busch
  • 通讯作者:
    Susan H Busch
Two steps forward, one step back? Implications of the Supreme Court's health reform ruling for individuals with mental illness.
前进两步,后退一步?
  • DOI:
    10.1001/jamapsychiatry.2013.25
  • 发表时间:
    2013
  • 期刊:
  • 影响因子:
    25.8
  • 作者:
    Ezra Golberstein;Susan H Busch
  • 通讯作者:
    Susan H Busch
Declines in psychiatric care in inpatient settings in Israel mirror global trend

Susan H Busch的其他文献

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{{ truncateString('Susan H Busch', 18)}}的其他基金

Substance use disorder treatment centers and facility ownership changes
药物滥用障碍治疗中心和设施所有权变更
  • 批准号:
    10680862
  • 财政年份:
    2023
  • 资助金额:
    $ 63.7万
  • 项目类别:
Alternative payment models and alcohol use disorder treatment and consequences
替代支付模式和酒精使用障碍治疗及后果
  • 批准号:
    10642757
  • 财政年份:
    2022
  • 资助金额:
    $ 63.7万
  • 项目类别:
Young adults, health care use and psychosis
年轻人、医疗保健使用和精神病
  • 批准号:
    9028539
  • 财政年份:
    2016
  • 资助金额:
    $ 63.7万
  • 项目类别:
Expanding Treatment of Opioid Dependence Among the Privately Insured
扩大私人受保人对阿片类药物依赖的治疗
  • 批准号:
    8117251
  • 财政年份:
    2009
  • 资助金额:
    $ 63.7万
  • 项目类别:
Expanding Treatment of Opioid Dependence Among the Privately Insured
扩大私人受保人对阿片类药物依赖的治疗
  • 批准号:
    7924579
  • 财政年份:
    2009
  • 资助金额:
    $ 63.7万
  • 项目类别:
Expanding Treatment of Opioid Dependence Among the Privately Insured
扩大私人受保人对阿片类药物依赖的治疗
  • 批准号:
    8287681
  • 财政年份:
    2009
  • 资助金额:
    $ 63.7万
  • 项目类别:
Antidepressant Use and Suicide
抗抑郁药的使用和自杀
  • 批准号:
    7684635
  • 财政年份:
    2007
  • 资助金额:
    $ 63.7万
  • 项目类别:
Antidepressant Use and Suicide
抗抑郁药的使用和自杀
  • 批准号:
    7300000
  • 财政年份:
    2007
  • 资助金额:
    $ 63.7万
  • 项目类别:

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