DRUG ABUSE TREATMENT COSTS OF MEDICAID CLIENTS IN AN HMO

健康维护组织(HMO)注册人数的急剧增长 加剧了人们对可用于治疗的充分性的担忧 有药物滥用问题的人。这是一个特别的话题 越来越多的州现在正在取代按如下方式收费的州- 为医疗补助客户提供首屈一指的医疗保健系统服务，其中许多 他们有严重的药物滥用问题。如果这是真的，这可能会扰乱 连续性护理并导致患有以下疾病的医疗补助客户的预后较差 药物滥用问题。 这项研究的广泛目的是为了更好地了解 医疗保健机构对医疗补助对象的药物滥用治疗，以改善 照顾参加医疗补助的人。具体目标是： 1.描述医疗补助的投保期限、服务用途和成本护理 寻求治疗化学依赖的资助参保者； 2.比较注册持续时间、服务使用情况和护理成本 使用非医疗补助HMO软管的化学依赖性医疗补助客户 参与者；以及 3.开发旨在提高预测的风险调整模型 医疗补助人群的化学依赖治疗费用。 决策者可以使用这项研究的信息来制定政策，以 改善医疗补助客户在医疗保健组织中的留存率并设置PER 会员每月的医疗补助计划付款率。政策 制造商尤其需要关于医疗补助人口亚群的成本数据 例如儿童和青少年。

The dramatic growth in health maintenance organizations (HMO) enrollment has heightened concern about the adequacy of treatment available for persons with substance abuse problems. This topic is of particular interest to the growing number of states that are now replacing fee-for- service with capitated health care systems for Medicaid clients, many of whom have severe substance abuse problems. If true, this could disrupt continuity of care and lead to poorer outcomes for Medicaid clients with substance abuse problems. The broad purpose of this study is to provide a better understanding of substance abuse treatment for Medicaid clients in HMOs in order to improve care for Medicaid enrollees. The specific aims are: 1. To describe enrollment duration, service use, and cost care of Medicaid funded enrollees seeking treatment of chemical dependency; 2. To compare enrollment duration, service use, and cost of care of chemically dependent Medicaid clients with hose of non-Medicaid HMO enrollees; and 3. To develop a risk adjustment model designed to improve the prediction of chemical dependency treatment costs for the Medicaid population. Decision makers could use information from this study to set policies to improve the retention of Medicaid clients in HMOs and for setting per member per month payment rates for capitated Medicaid programs. Policy makers especially need cost data on sub-groups of the Medicaid population such as children and youth.