Treatment Centers

New health care reform included some measures that may dramatically impact substance abuse treatment facilities. Under the new laws, some people may be able to access health insurance that will cover some of the costs of substance abuse treatment. For instance, young adults who “aged out” at age 19 under previous insurance law are now able to retain coverage until they turn 26.

With these changes in mind, it is important to assess whether the substance abuse treatment facility network is equipped to deal with the possible increase in patients. The National Survey of Substance Abuse Treatment Services (N-SSATS) is an annual assessment of all facilities in the United States, and provides valuable information on various aspects of treatment.

The latest report indicates that in 2008, 13,688 substance abuse facilities responded to the N-SSATS. Of those facilities reporting, 539 provided treatment to all clients at no charge, and therefore are not included in this discussion of the impact of private health insurance on treatment facilities. Of the facilities remaining, almost two-thirds accepted private health insurance.

The survey asked the treatment facilities to report on their primary focus of treatment. The results indicated that facilities that identified themselves as having a primary focus of mental health services, general health care or a mix of mental health and substance abuse treatment services were more likely than locations with a focus on substance abuse treatment to accept private health insurance.

The type of organization operating the facility seemed to have little effect on whether private health insurance was accepted. While almost all of the reporting facilities accepted cash or self-payment, those that accepted private health insurance were also more likely to accept government health insurance. In addition, facilities that accepted private health insurance were more likely to offer a sliding fee scale to their patients.

Treatment facilities that accepted private health insurance were more likely than those that did not to have a relationship with a managed care organization (67 percent versus 20 percent). However, both facilities that accepted private health insurance and those that did not were equally likely to receive government funding or government grants to support their programs.

Almost all of the facilities that offered inpatient treatment for substance abuse also accepted private health insurance, and approximately two-thirds of the facilities that offered outpatient services accepted private health insurance. Only 54 percent of facilities that offered residential care accepted private health insurance.

With health care changes occurring that could make a significant impact on treatment facilities for substance abuse, it is important to evaluate the capacity of these facilities to accept more patients. With information gathered by the N-SSATS, policymakers will be able to better understand how to help the facilities effectively treat a possible influx of patients.