McCarty Dennis, Argeriou Milton
Department of Public Health & Preventive Medicine, CB669, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97201, USA.
J Behav Health Serv Res. 2003 Jan-Feb;30(1):18-25. doi: 10.1007/BF02287810.
The Iowa Managed Substance Abuse Care Plan (IMSACP) used a behavioral health care organization to manage expenditures for treatment of alcohol and drug dependence financed through Medicaid, block grants, and state appropriations but maintained relatively distinct eligibility and benefit structures for Medicaid-eligible individuals. Medicaid claims, encounters, and eligibility files were reviewed for 2 years before and 3 year after implementation of IMSACP to evaluate changes in access, utilization, and expenditures. The rate of substance abuse treatment doubled, use of inpatient hospital services decreased, and residential and outpatient services increased. Direct care costs decreased, while total expenditures held steady. The Iowa experience suggests that a well-planned initiative can control costs and improve access and utilization.
爱荷华州药物滥用管理护理计划（IMSACP）利用一个行为健康护理组织来管理通过医疗补助、整笔拨款和州拨款资助的酒精和药物依赖治疗费用，但为符合医疗补助条件的个人维持了相对不同的资格和福利结构。在实施 IMSACP 之前的 2 年和之后的 3 年，对医疗补助索赔、诊疗记录和资格档案进行了审查，以评估获得治疗的机会、使用情况和费用的变化。药物滥用治疗率翻了一番，住院医院服务的使用减少，住院和门诊服务增加。直接护理成本下降，而总支出保持稳定。爱荷华州的经验表明，精心规划的举措可以控制成本并改善获得治疗的机会和利用率。
