Managed-Care Program Provides Treatment on Request February 27, 2001
News Summary
Detroit, Mich., is seeing positive results from the state's move to a Medicaid managed-care system for addiction and mental health services, Alcoholism & Drug Abuse Weekly reported Jan. 15.Under the state's managed-care system, addiction services are overseen by 15 regional coordinating agencies throughout the state. Medicaid clients with addiction problems are assessed within 48 hours, or 24 hours in urgent-care situations.
Treatment providers take all patients referred to them by the Bureau of Substance Abuse and are paid on a fee-for-service basis. "We had been contracting with providers for slots," said Calvin Trent, director of the Bureau of Substance Abuse in Detroit's Department of Health. "So in some cases, providers had plenty of room, but since the contract called for only 100 slots, they didn't take any additional Medicaid patients."
He added, "We've been able to service all of our clients on demand and still come in under our capitation rate. The capacity was there all the time."
In addition to using a fee-for-service system for addiction treatment under Medicaid, the city of Detroit also uses fixed rates for block-grant-funded services. As a result, providers of residential treatment receive no more or less for treating a Medicaid or a block-grant-funded patient. "We're getting to a place where almost all providers in the city are providing both Medicaid and block grant services," Trent noted.
The new system also has erased waiting lists for all levels of treatment, including outpatient, residential, and methadone maintenance. According to Trent, most indigent and Medicaid clients in Detroit who request treatment receive services on the same day.
"The system is working pretty well," said Jeanett Dave, administrative assistant at MetroEast, a methadone treatment provider with three clinics in Detroit. "And from the perspective of people who really want treatment, they are readily getting into treatment."
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