Variation in Staff Salary Costs Associated with Characteristics of Substance Use Disorder Treatment Facilities

Variation in Staff Salary Costs Associated with Characteristics of Substance Use Disorder Treatment Facilities

Research Data Brief
Published: Jun 30, 2021
Publisher: Mathematica and Eagle Technologies
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Associated Project

National Surveys of Mental Health and Substance Use Disorder Treatment Facilities

Time frame: 2016-2021

Prepared for:

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration

Authors

Monica Farid

Key Findings
  • Average 2016 annual cost of staff salaries per client caseload varied substantially across the three facility types analyzed, with outpatient opioid treatment programs (OTPs) having the lowest cost ($4,576), followed by outpatient non-OTPs ($16,873) and residential non-OTPs ($33,927).
  • For each of the three facility types examined, facilities in the lowest quartile for size had per-client salary costs 89 percent or more higher than the average facility of the same type.
  • For outpatient OTPs, staff salary costs were not associated with the range of SUD testing and support services provided. For both outpatient and residential non-OTPs, the regression results indicate that facilities with the most limited provision of these services have the lowest costs.
  • Outpatient non-OTPs that reported that they primarily focus on mental health services or general health care and provide a broad range of mental health services had higher staff salary costs than the average outpatient non-OTP. Residential non-OTPs that reported that they primarily focus on a mix of mental health and substance use disorder treatment services and provide a broad range of mental health services had higher staff salary costs than the average residential non-OTP.

In the context of the movement to value-based payment models that reimburse providers for a package of services rather than individual procedure codes, state Medicaid programs and substance use disorder (SUD) treatment facilities face the challenge of setting reimbursement rates that will adequately cover the cost of a range of SUD treatment services and client populations. Such uncertainty about payment rates inhibits facilities from entering into value-based payment arrangements and expanding services to underserved populations. Staffing is the main cost driver for facilities, but little information is available to states or facilities on how facility characteristics affect staffing levels. This analysis provides information on staffing costs that states and SUD treatment facilities can use to inform development of value-based payment approaches.

Specifically, this brief combined workforce data from the National Survey of Substance Abuse Treatment Services (N-SSATS) for 2016 (the most recent year in which N-SSATS collected workforce data) with national data on labor force costs for 2016 for professions involved in SUD treatment to examine variations in staffing costs associated with characteristics of SUD treatment facilities.

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