Researchers Study Utilization and Costs for Medicaid and Non-Medicaid Patients Seeking Substance Abuse Treatment Through a California HMO

Comparison of utilization patterns and costs for Medicaid and non-Medicaid chemical dependency patients in a group model HMO

From November 1998 through October 2001, Lawrence J. Walter and colleagues at the Kaiser Permanente Division of Research examined health care utilization and costs for patients with chemical dependence who received health care and substance abuse services at the Kaiser Permanente Medical Care Program, a group model health maintenance organization (HMO) in California.

The project was part of the Robert Wood Johnson Foundation's (RWJF) national Substance Abuse Policy Research Program (SAPRP) (for more information see the Program Results Report).

Key Findings:

  • Compared to chemically dependent non-Medicaid patients, chemically dependent Medicaid patients were less likely to initiate substance abuse treatment (58% versus 66%) and remained in treatment for shorter periods (14 days versus 28 days).
  • Health care costs for chemically dependent patients decreased 33 percent for Medicaid patients and 25 percent for non-Medicaid patients over the three years following their recommendation to treatment.
  • Health care costs for patients who were not chemically dependent increased 53 percent for Medicaid patients and 33 percent for non-Medicaid patients over the three-year period.