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Impact of health reform on outpatient substance abuse treatment programs

Award Number: R01DA034634
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/01/2016
PERIOD OF PERFORMANCE END DATE: 01/31/2020

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Impact of health reform on outpatient substance abuse treatment programs - DESCRIPTION (provided by applicant): Small (average of 15 full-time staff members), under-resourced organizations that comprise the outpatient substance abuse treatment (OSAT) system provide most drug abuse treatment in the United States. Implementation of the Patient Protection and Affordable Care Act (PPACA) of 2010 will dramatically change the organizational environment for these organizations. Regardless of the outcome of the constitutional challenge to PPACA, the expansion of Medicaid, the development of Health Insurance Exchanges and the mandate to include substance abuse treatment in essential benefits packages will greatly expand the number of Americans whose health insurance covers OSAT services and thus alter the payer mix in OSAT programs. The emphasis on integrated models of care, including patient-centered medical homes and Accountable Care Organizations, creates incentives for care coordination. These reforms will generate sweeping changes in the financing, organization and accessibility of OSAT care. The proposed study applies open systems and resource dependence theory to examine two major aspects of health reform - the expansion of insurance and incentives for integration of substance abuse treatment with mainstream health care - that are likely to influence OSAT programs' organizational responses (i.e. use of technology, staffing, affiliations and alliances) as well as the accessibility and quality of drug abuse treatment. That said, the PPACA faces legal, political, fiscal, and implementation uncertainties. Organizational theory suggests that such uncertainties will increase OSAT programs' concerns about obtaining resources necessary for functioning and survival, leading to closer alignment and mergers among organizations. The proposed study will explicitly model this environmental uncertainty as a moderator of OSAT organizational responses. We will survey a nationally-representative sample of 500 OSAT programs in summer 2013 to examine the extent to which OSAT programs are acting in anticipation of the new organizational environment. We also propose semi-structured interviews with the directors of the 50 single-state agencies for substance abuse treatment and in-depth qualitative interviews with key legislative stakeholders to assess state preparations and anticipatory changes from the PPACA. By re-surveying the 500 OSAT programs in winter 2015 we will determine the post-implementation impact of the PPACA on OSAT organizational responses and service delivery. A panel data set will be formed by linking the survey and interview data to data from the National Drug Abuse Treatment System Survey (NDATSS) collected during 2000 and 2005, which will provide a true baseline of OSAT programming and services prior to enactment of both the PPACA and the Mental Health Parity and Addiction Equity Act of 2008. This study will enable us to examine the impact of health reform on the nation's OSAT system and provide high-quality information to policy makers and stakeholders to evaluate the effectiveness of the PPACA in improving the accessibility and quality of substance abuse treatment. 1


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2020 ( Subtotal = -$8,232 )
2020	2017	BAYSTATE HEALTH SYSTEM HEALTH SERVICES, INC.	759 CHESTNUT ST	SPRINGFIELD	MA	01199	HAMPDEN	USA	Drug Use and Addiction Research Programs	003	5	6/23/2020	NON-COMPETING CONTINUATION	$95,174
2020	2017	BAYSTATE HEALTH SYSTEM HEALTH SERVICES, INC.	759 CHESTNUT ST	SPRINGFIELD	MA	01199	HAMPDEN	USA	Drug Use and Addiction Research Programs	004	5	6/25/2020	NON-COMPETING CONTINUATION	-$103,406
2020	2017	BAYSTATE HEALTH SYSTEM HEALTH SERVICES, INC.	759 CHESTNUT ST	SPRINGFIELD	MA	01199	HAMPDEN	USA	Drug Use and Addiction Research Programs	002	5	2/6/2020	NON-COMPETING CONTINUATION	-$103,406
2020	2017	BAYSTATE HEALTH SYSTEM HEALTH SERVICES, INC.	759 CHESTNUT ST	SPRINGFIELD	MA	01199	HAMPDEN	USA	Drug Use and Addiction Research Programs	000	5	1/17/2020	NON-COMPETING CONTINUATION	-$103,406
2020	2017	BAYSTATE HEALTH SYSTEM HEALTH SERVICES, INC.	759 CHESTNUT ST	SPRINGFIELD	MA	01199	HAMPDEN	USA	Drug Use and Addiction Research Programs	001	5	2/5/2020	NON-COMPETING CONTINUATION	$206,812
														Subtotal = -$8,232

Issue Date FY: 2019 ( Subtotal = $0 )
2019	2017	BAYSTATE HEALTH SYSTEM HEALTH SERVICES, INC.	759 CHESTNUT ST	SPRINGFIELD	MA	01199	HAMPDEN	USA	Drug Use and Addiction Research Programs	000	5	6/21/2019	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2017 ( Subtotal = $488,574 )
2017	2017	BAYSTATE HEALTH SYSTEM HEALTH SERVICES, INC.	759 CHESTNUT ST	SPRINGFIELD	MA	01199	HAMPDEN	USA	Drug Use and Addiction Research Programs	000	5	1/5/2017	NON-COMPETING CONTINUATION	$439,716
2017	2017	BAYSTATE HEALTH SYSTEM HEALTH SERVICES, INC.	759 CHESTNUT ST	SPRINGFIELD	MA	01199	HAMPDEN	USA	Drug Use and Addiction Research Programs	001	5	5/22/2017	NON-COMPETING CONTINUATION	$48,858
														Subtotal = $488,574

Issue Date FY: 2016 ( Subtotal = $708,258 )
2016	2016	BAYSTATE MEDICAL CENTER	759 CHESTNUT STREET	SPRINGFIELD	MA	01199	HAMPDEN	USA	Drug Use and Addiction Research Programs	000	4	2/25/2016	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$708,258
2016	2015	RHODE ISLAND HOSPITAL	593 EDDY ST, ALDRICH 317	PROVIDENCE	RI	02903	PROVIDENCE	USA	Drug Use and Addiction Research Programs	001	3	2/25/2016	NON-COMPETING CONTINUATION	$0
														Subtotal = $708,258

Issue Date FY: 2015 ( Subtotal = $930,907 )
2015	2015	RHODE ISLAND HOSPITAL	593 EDDY ST, ALDRICH 317	PROVIDENCE	RI	02903	PROVIDENCE	USA	Drug Use and Addiction Research Programs	000	3	2/10/2015	NON-COMPETING CONTINUATION	$930,907
														Subtotal = $930,907

Issue Date FY: 2014 ( Subtotal = $881,167 )
2014	2014	RHODE ISLAND HOSPITAL	593 EDDY ST, ALDRICH 317	PROVIDENCE	RI	02903	PROVIDENCE	USA	Drug Use and Addiction Research Programs	000	2	1/8/2014	NON-COMPETING CONTINUATION	$793,050
2014	2014	RHODE ISLAND HOSPITAL	593 EDDY ST, ALDRICH 317	PROVIDENCE	RI	02903	PROVIDENCE	USA	Drug Use and Addiction Research Programs	001	2	2/27/2014	NON-COMPETING CONTINUATION	$88,117
														Subtotal = $881,167

Issue Date FY: 2013 ( Subtotal = $981,880 )
2013	2013	RHODE ISLAND HOSPITAL	593 EDDY ST, ALDRICH 317	PROVIDENCE	RI	02903	PROVIDENCE	USA	Drug Use and Addiction Research Programs	001	1	6/6/2013	SUPPLEMENT FOR EXPANSION	$222,412
2013	2013	RHODE ISLAND HOSPITAL	593 EDDY ST, ALDRICH 317	PROVIDENCE	RI	02903	PROVIDENCE	USA	Drug Use and Addiction Research Programs	000	1	4/25/2013	NEW	$759,468
														Subtotal = $981,880

Grand Total All Awards = $3,982,554

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Impact of health reform on outpatient substance abuse treatment programs

Award Number: R01DA034634

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/01/2016

PERIOD OF PERFORMANCE END DATE: 01/31/2020

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