The effect of copayments on drug and alcohol treatment following inpatientdetoxification under managed care

Objective: The study examined the rate and duration of outpatient substance abuse treatment following inpatient detoxification under managed care, Met hods: Seven years of claims data fi-om a large behavioral health care carve -out plan were used to identify patients. Rates and duration of formal subs tance abuse treatment following detoxification were calculated, and regress ion models were used to explore factors that may affect participation in tr eatment. Results: Seventy-nine percent of the detoxification patients recei ved formal substance abuse treatment, the majority within the week followin g discharge. Formal follow-up care lasted an average of ten weeks, with vis its occurring on average about once a week. When other variables likely to influence participation in substance abuse treatment were controlled for, t he level of outpatient copayments significantly affected the rate of partic ipation in treatment. Conclusions: These findings indicate that the rate of participation in outpatient treatment after detoxification is high, but ro om for improvement remains. The results suggest that reducing copayment lev els is one mechanism for increasing the likelihood that individuals with se vere drug and alcohol problems will receive subsequent treatment. The need for such treatment is underscored by the severity of illness of those who u ndergo detoxification and the societal costs of untreated substance use dis orders.