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Alabama Cost Study

Alabama Cost Study. SAMHSA-funded consultants JBS International Sigrid Hutcheson, PhD Thomas Lucking, EdS. Purpose: Inform SASD rate setting process. . Some standards add costs. SASD -- reasonable cost of high quality, efficient care. Cost study is the widely used approach.

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Alabama Cost Study

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  1. Alabama Cost Study SAMHSA-funded consultants JBS International Sigrid Hutcheson, PhD Thomas Lucking, EdS

  2. Purpose: Inform SASD rate setting process. • Some standards add costs. • SASD -- reasonable cost of high quality, efficient care. • Cost study is the widely used approach. • Also benchmarks, careful of the apples/oranges issue.

  3. Parameters • Provider $ treated as proprietary. • Scope: SA regardless of payer source. • Apart from the costs of SA services: • Information not already disclosed in the audits is not required.

  4. Documents Read all directions carefully before starting. Three documents: • Word document, directions • Excel workbook • Word document, Explanatory Notes

  5. Cost study needs: • Actual costs. • Tied to an audit is most useful. • Recent year is available for most. • Keeps study in the real world. • Projected, 12 month period. • Explanatory Notes needed for meaning.

  6. Calculating unit costs • Cost/Services. • Simple for organizations with a single service. • Still need SA cost detail in all cases. • With multiple service programs. • Identify costs directly traceable to programs. • Identify support costs (admin.) not traceable to programs. • Assign proportion of admin. to each program. • Then divide costs by service units. • Logical, defensible, and consistent, with the results being transparent

  7. SASD intends to: • Cover reasonable costs, including those resulting from new standards. • Pay differentials for some services by credential. • Pay for EBPs, such as medication assisted tx. • Many, many possible cost variations. 

  8. You may go through the whole process for the costs of all rates • We also offer an easier, softer way. • Option of using automated worksheets for group/individual. • Not necessary to treat each rate (e.g. babysitting) as a separate program.

  9. Option of limited cost reporting • Use “other” program to report totals for all non-SA programs and FTEs. • Line item details not needed. • May do the same for admin., although explain significant variations from the audited admin. amount. • Need detail for SA: • What’s driving costs? • Assess efficiency. • Impact of new standards and credentials costs.

  10. Residential Treatment Programs • Crisis Residential Program (ASAM Level III.5) • Residential Rehabilitation Program (ASAM Level III.1) • 16 or fewer beds: treat the counseling as a distinct outpatient program. • Separate calculations for specialty programs: adult, adolescent, co-occurring disorders, and women and children’s.

  11. Outpatient Treatment Programs • Outpatient Program (ASAM Level I.) • Intensive Outpatient Program (ASAM Level II.1) • Partial Hospitalization Program (ASAM (Level II.5) • Separate calculations for specialty programs: adult, adolescent, co-occurring disorders, and women and children’s specialty.  

  12. Also for outpatient: • Calculate costs for group and individual services. • Use cost analysis steps with group and individual as different service programs. • Or use the automated worksheet to determine proportion.

  13. Opioid Treatment, cost out two service programs: • All services other than counseling as a single program, cost/day. • Counseling services as an Outpt. Program.

  14. Detoxification • A single service cost/day. • Medically Monitored Residential (ASAM Level III.D) • Ambulatory Without Extensive Onsite Monitoring (ASAM Level I-D)

  15. Many additional categories because SASD wishes to $ for best practices. • Cost as many as you believe would be helpful. • (We may rely on benchmarks for some.) • May identify cost impact within programs in the Explanatory Notes and line items detail. • Example: cost of medication assisted tx on group and individual costs.

  16. Explanatory Notes Document • Use to describe the assignment of costs when these are not self-evident. • Include anything that would add meaning to the study. • Special mention of when added services may distort group/individual costs.

  17. Explanatory Notes, actual, explain: • Substantial difference between audited admin and admin. for the study. • Identify and attach the page from the audit that ties total organization’s expenses to those reported in the workbook. • Present the bases of estimates when actual data is not available.

  18. For projected costs, please explain: • The reason for any substantial increase or decrease in costs. • Refer to the line item detail in the workbooks. • The more concrete and specific the explanation the more useful it will be.

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