Appendix B — Treatment of Patients With Dual Disorders: Sample Cost Data
To provide readers with illustrative data on the costs of running programs for patients with dual disorders, the consensus panel Chair obtained data on actual costs during fiscal year 1991-1992 from three programs in urban areas. One program, on the West Coast, provided day and evening intensive outpatient services. The second, in the Northeast, provided intensive outpatient services during the day. In the third program, in the Northwest, daytime intensive outpatient services, partial hospitalization, and intensive case management were provided.
Included in the tables below are descriptive data for each program, including institutional status (for example, private for-profit or public), payer mix (for example, Medicaid or self-pay patients), number of clients served (at 100 percent capacity), salary ranges of various levels of staff, and other expenses (for example, facility costs). Total expenses and total revenues for each program are listed at the end.
TREATMENT OF PATIENTS WITH DUAL DISORDERS SAMPLE COST DATA
Program 1 Program 2 Program 3
___________________________________________________________
PROGRAM TYPE
Evening Intensive X
Outpatient
Day Intensive X X X
Outpatient
Partial X
Hospitalization
Other Day treatment
and intensive
case
management
___________________________________________________________
REGION West Coast Northeast Northwest
___________________________________________________________
LOCALE Urban Urban Urban
___________________________________________________________
INSTITUTIONAL STATUS
___________________________________________________________
Private for-profit X
Private nonprofit
Public X X
Other
___________________________________________________________
PAYER MIX (BY PERCENT)
___________________________________________________________
Insurance/Managed X
Care
Medicaid 66% 30%
Medicare X 25%
Self-pay X 4%
HMO contract X
State grant/purchase 30% 45%
of care
TREATMENT OF PATIENTS WITH DUAL DISORDERSSAMPLE COST DATA
Program 1 Program 2 Program 3
____________________________________________________________________________________________
NUMBER OF PATIENTS SERVED (AT 100 PERCENT CAPACITY)
____________________________________________________________________________________________
Daily 50+ 45 100
Weekly 320 225 300
____________________________________________________________________________________________
SALARY RANGES
____________________________________________________________________________________________
Administrators/managers $60,000 to 70,000 $38,000 to 50,000 $35,000 to 60,000
Physicians $70/hour to $85,000 $70,000 to 90,000
100/hour
Social workers $30,000 to 50,000 $30,000 $26,000 to 35,000
Psychologists $50,000 to 60,000 n/a $50,000 to 70,000
Support staff $18,000 to 27,000 $20,000 to 29,000 $22,000 to 28,000
Other Addiction Nurses, Addiction
counselors, counselors and mental health
$23,000 to 35,000 recreational specialists
therapists $23,000 to 33,000
$25,000 to 38,000 -----------------
Nurses
$32,000 to 48,000
TREATMENT OF PATIENTS WITH DUAL DISORDERS SAMPLE COST DATA
__________________________________________________________________________
Program 1 Program 2 Program 3
__________________________________________________________________________
OTHER EXPENSES (BY PERCENT)
__________________________________________________________________________
Administrative overhead 7.1% 24% 20%
Personnel (including 80.5% 60% 70%
fringe benefits)
Facility costs 12.4% 16% 10%
__________________________________________________________________________
TOTAL EXPENSES FY 1991-1992 TOTAL REVENUES
FY 1991-1992
__________________________________________________________________________
Program 1 $482,000 $489,000
Program 2 $811,052 $561,052
Program 3 $2,200,000 $1,980,000
__________________________________________________________________________
Integrated Treatment of Substance Abuse & Mental Illness