Impact of patient placement criteria on substance abuse treatment under the Oregon Health Plan

When Oregon shifted to managed care for Medicaid-funded substance abuse treatment, standardized patient placement and discharge criteria were rapidly implemented statewide. This prospective, naturalistic study examines the validity and impact of placement criteria with a sample of 240 adults presenting for treatment compared to a sample of 287 in Washington state, where implementation was phased in slowly. Baseline profile analysis suggested better differentiation between Level II and Level III clients for the Oregon sample and better implementation than with the Washington sample, presumably because Oregon clinicians received more training and had more experience with the criteria. A majority of the Oregon sample was placed in intensive outpatient programs, consistent with the recommended level of care. In this study, placement criteria showed good potential for changing treatment planning behavior, increasing individualization, and improving utilization of new levels of care.