The Costs of Implementing Collaborative Care for Opioid and Alcohol Use Disorders in Primary Care

by Priscillia Hunt, Allison J. Ober, Katherine E. Watkins

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Research Question

  1. What are the costs associated with implementation of the substance use motivation and medication integrated treatment program?

The National Institutes of Health provided a grant to the RAND Corporation to identify the costs associated with implementation of a collaborative care treatment program for opioid and alcohol use disorders. Between 2012 and 2016, RAND studied the implementation of the substance use motivation and medication integrated treatment (SUMMIT) program in a multi-site large urban federally qualified health center (FQHC) in Los Angeles County. This report describes the costs of the program, separating the resources spent by the FQHC and the external facilitators of the SUMMIT program. The findings of this study are based on a bottom-up, activity-based costing approach to determine the staff time spent (labor costs) on the program and any minor equipment expenses. Rather than simply log all the labor and equipment costs incurred for the study, we provide the costs that another facility of this size might expect to incur. We include costs that take into account the lessons learned about how many people with particular job roles should participate in meetings, trainings, and other activities. Therefore, although the focus of this study is one larger health center in Los Angeles County, we believe other large treatment facilities and health clinics may find the results of interest as well.

Key Findings

  • Over a 3.5-year period, the total one-time, start-up cost to prepare for organizational readiness and ongoing maintenance costs to deliver treatment using collaborative care was $185,491 for primary care resources and an estimated $178,821 for external facilitation.
  • Using the rate of 114,000 patients seen per year for this primary care clinic, the estimated cost for primary care resources was $0.46 per patient seen.
  • In terms of time spent by primary care professionals, this study provides breakdowns of the number of meetings, length of time, and the attendees by job type.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Method and Data

  • Chapter Three

    Results

  • Chapter Four

    Discussion

Research conducted by

The research described in this report was prepared for the National Institutes of Health and conducted RAND Health.

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