Understanding the trends: a guide to cooperation between treatment centers and managed care providers.

UNDERSTANDING THE TRENDS: A Guide to Cooperation Between Treatment Centers and Managed Care Providers

THE PROBLEMS

Rapid expansion

During the late 1960s and early 1970s, the nation accepted alcoholism as a disease and recognized the need for treatment. Everyone was so sold on treatment that many companies were willing to provide unlimited insurance coverage for their employees and family members with chemical dependency problems. This policy led to a proliferation of new treatment facilities which continued into the mid to late 1980s.

The proliferation was mainly the result of the drive for profits by large health care corporations. Most treatment centers enjoyed a 70-100 percent occupancy rate and waiting lists were common. The economic success was so resounding that it led to many of the current problems experienced by the chemical dependency field.

lack of accountability

As the economic successes continued, the major goal became the continued expansion of centers. Programs were not held accountable for proof of effective treatment. Chemical dependency professional knew treatment worked "if the patients would just work their recovery program." And that meant completion of a predetermined number of inpatient treatment days coupled with some type of aftercare and AA/NA attendance. Treatment alternatives were few because no demand for them existed. There was no internal or external motivation to change. consequently, the chemical dependecy field never created the systems necessary for internal accountability.

Rigid adherence to the Minnesota

Model of treatment

The Minnesota Model began in 1948 with the Pioneer in Minneapolis, Minnesota. It gave rise to the concept of inpatient hospital treatment for alcoholism and was later expanded to include chemical dependency. Prior to detoxification, behavioral modification and psychiatric treatment geared toward addressing the symptoms of the diseas and not the disease itself. Few remained abstinent with these treatment

With the rapid expansion of treatment facilities, the Minnesota Model became the accepted form of chemical dependency treatment for a number of reasons. It worked better in helping chemically dependent individuals recover than any methods previously tried. In the 1986 CATOR Report by Hoffman and Harrison, 1,001 adult patients from four treatments centers using the Minnesota Model were studied. Fifty-eight percent of the patients studied maintained continuous abstinence for two years following treatment, 18 percent relapsed, and 14 percent experienced sporadic abstinence.

The Minnesota Model was easy to replicate and then following in a treatment setting. It was also relatively inexpensive to install and worked well with the AA Philosophy. The standardized 28-day inpatient treatment model consists of medically supervised detoxification to treat the acute abstinence syndrome, educational components and group therapy, weekly aftercare for at least three months and a belief in lifelong AA/NA attendance.

Though the Minnesota Model has been relatively effective in treating …