SAMHSA survey: 65% of substance abuse treatment facilities accept private health insurance

A new nationwide survey of substance abuse treatment facilities reveals that in 2008 nearly two thirds (65 percent) accepted some private health insurance payment.  The survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) also indicated that there were significant differences in the level of private insurance payment acceptance among different types of substance abuse treatment facilities.

For example, private insurance payment was accepted by 85 percent of facilities with a primary focus on mental health services, 82 percent of facilities offering general health care, and 78 percent of facilities offering a mix of mental health and substance abuse treatment services.  On the other hand, private insurance payment was accepted by only 56 percent of facilities primarily focused on substance abuse treatment services and 37 percent of facilities focused on other services (e.g., providing shelter for people experiencing homelessness).

"The ability to bill third party payers including private insurers and Medicaid is critical to the survival of treatment facilities," said SAMHSA Administrator Pamela S. Hyde, J.D.  "The dramatic increase in numbers of people covered with health insurance that includes coverage for mental and substance use disorders will revolutionize the behavioral health field.  Treatment facilities need to be preparing now and SAMHSA has technical assistance resources available to help." 

The study noted that substance abuse treatment facilities that accepted private insurance payments were far more likely than those that did not to accept payment from other sources such as Medicaid (68 percent versus 31 percent), state-financed health insurance (53 percent versus 14 percent) and Medicare (48 percent versus 12 percent).

This capacity of substance abuse programs to bill Medicaid may become more critical as Medicaid's coverage of substance abuse services becomes more comparable to its coverage of mental health services.  

Other significant differences between treatment programs that accepted private insurance payment and those that did not include the use of cognitive-behavioral therapy services at their facilities (70 percent versus 58 percent).  Facilities accepting private insurance were more likely than others to accept adolescents into their programs (58 percent versus 33 percent).

The study also showed that treatment facilities located in more central large urban areas were less likely than rurally situated facilities to accept private insurance payment (54 percent versus 78 percent).  In general the further away facilities were from central city areas, the more likely they were to accept private insurance payment.

The study, Acceptance of Private Health Insurance in Substance Abuse Treatment Facilities is based on data from SAMHSA's Treatment Episode Data Set (TEDS) - a reporting system involving treatment facilities from across the country.  The study was developed as part of SAMHSA's strategic initiative on data, outcomes, and quality - an effort to inform policy makers and service providers on the nature and scope of behavioral health issues.