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