Medicaid Substance Abuse Treatment Spending: Findings Report. TABLE F.9. Summary of Imputation for Enrollees with Coverage of SA Under Managed Care

09/28/2012

TABLE F.9. Summary of Imputation for Enrollees with Coverage of SA Under Managed Care

StateBasis for ImputationNumber of Enrolled Months, 12+% of Months with Expenditures Imputed% of Months Imputed Based on FFS StatesCore Expenditures per Enrolled Month, 12+Specialty SA Treatment Supply CategoryNotes
Total 329,928,72242.433.410.20  
Alabama (AL)No managed care SA coverage4,508,4290.00.01.84Low 
Alaska (AK)No managed care SA coverage659,9310.00.010.24MediumOnly 57% of OT file claims have primary diagnosis code
Arizona (AZ)Encounter data for full-benefit core SA services, AZ FFS experience for all others8,892,31175.19.516.06Medium 
Arkansas (AR)No managed care SA coverage3,419,4170.00.01.45Low 
California (CA)CA FFS experience for disabled & partial-benefit/Tier I & Tier II state experience for adults & children48,737,82541.333.06.50MediumInstitutional long-term care claims have only one diagnosis code. Not able to load one of 50 other service file claim CDs.
Colorado (CO)Tier I & Tier II state experience2,770,43092.292.221.72HighBHO is assumed to cover SA services although these services are not specifically mention in the program summary
Connecticut (CT)CT FFS experience for full-benefit/Tier I & Tier II state for duals & partial-benefit3,696,5474.70.514.82High 
Delaware (DE)Tier I & Tier II state experience1,151,09366.666.69.94Medium 
District of Columbia (DC)DC FFS experience for disabled/Tier I & Tier II state experience for all others1,203,12153.351.210.73HighOnly 9% of claims in the institutional long-term care file have a primary diagnosis
Florida (FL)FL FFS experience for adult, children & disabled/ Tier I & Tier II state experience for duals & partial-benefit.15,267,25528.23.02.68LowOnly 32% of institutional long-term care & 78% of other services file claims have a primary diagnosis code.
Georgia (GA)GA FFS experience for disabled/Tier I & Tier II state experience for all others8,008,47541.941.42.61Low 
Hawaii (HI)HI FFS experience for disabled/Tier I & Tier II state experience for all others1,575,35365.765.05.30LowOnly 75% of OT file claims have primary diagnosis.
Idaho (ID)No managed care SA coverage1,046,4610.00.02.29Low 
Illinois (IL)IL FFS experience full-benefit non-duals/Tier I & Tier II experience for all others15,996,5294.40.26.95Medium 
Indiana (IN)IN FFS experience for disabled/Tier I & Tier II state experience for all others5,948,45250.949.15.57Medium 
Iowa (IA)Tier I & Tier II state experience2,726,46871.671.63.66LowOnly 88% of institutional long-term care claims have a primary diagnosis code.
Kansas (KS)Encounter data for core SA services full-benefit enrollees & Tier I & Tier II expenditures for other services1,735,95183.328.29.77MediumExpenditures associated with care coordination for BHO are not included in claims data.
Kentucky (KY)No managed care SA coverage5,255,3030.00.07.03Medium 
Louisiana (LA)No managed care SA coverage6,447,1090.00.01.81LowOnly 87% of institutional long-term care claims have a primary diagnosis code.
Maine (ME)Tier I & Tier II state experience2,702,131100.0100.018.57HighMAX does not include inpatient hospital, institutional long-term care or other service claims for ME.
Maryland (MD)Tier I & Tier II state experience4,704,51866.866.814.34HighOnly 64% of institutional long-term care claims have a primary diagnosis code.
Massachusetts (MA)MA FFS experience full-benefit/Tier I & Tier II state experience duals & partial-benefit9,846,72629.00.010.07HighOnly 8% of institutional long-term care claims & 45% of other service file claims have a primary diagnosis code.
Michigan (MI)Tier I & Tier II state experience12,003,85849.949.95.48MediumOnly 80% of other service file claims have a primary diagnosis code.
Minnesota (MN)MN FFS experience for disabled/Tier I & Tier II state experience for all other4,614,97457.656.911.66Medium 
Mississippi (MS)No managed care SA coverage3,848,6210.00.05.23Low 
Missouri (MO)MO FFS experience full-benefit/Tier I & Tier II state experience duals & partial-benefit.5,949,24333.62.412.81Medium 
Montana (MT)No managed care SA coverage560,5970.00.010.95Medium 
Nebraska (NE)Tier I & Tier II state experience1,269,54776.476.414.14Low 
Nevada (NV)NV FFS experience for disabled/Tier I & Tier II state experience for adults & children1,213,27134.434.46.59High 
New Hampshire (NH)No managed care SA coverage816,2630.00.08.66Medium 
New Jersey (NJ)NJ FFS experience for disabled/Tier I & Tier II state experience for all others6,784,50760.653.110.78Medium 
New Mexico (NM)Tier I & Tier II state experience2,979,07253.753.79.64High 
New York (NY)NY FFS experience for disabled/Tier I & Tier II state experience for all others35,887,26160.655.231.69High 
North Carolina (NC)No managed care SA coverage8,900,8450.00.05.37Medium 
North Dakota (ND)No managed care SA coverage388,6890.00.011.01Medium 
Ohio (OH)OH FFS experience for disabled/Tier I & Tier II state experience for all others13,214,71762.053.613.91MediumOnly 88% of institutional long-term care claims have a primary diagnosis code.
Oklahoma (OK)No managed care SA coverage3,648,8150.00.02.50MediumOnly 89% of institutional long-term care claims have a primary diagnosis code.
Oregon (OR)Tier I & Tier II state experience2,905,50863.463.413.96HighOnly 51% of other service file claims have a primary diagnosis code.
Pennsylvania (PA)Tier I & Tier II state experience13,873,34689.489.47.43MediumOnly 80% of other service file claims have a primary diagnosis code.
Rhode Island (RI)RI FFS experience for disabled/Tier I & Tier II state experience for all others1,410,45751.549.814.25High 
South Carolina (SC)SC FFS Experience full-benefit/Tier I & Tier II state for all others4,725,34518.81.54.82MediumOnly 4% of institutional long-term care claims & 70% of other service file claims have a primary diagnosis code.
South Dakota (SD)No managed care SA coverage658,9470.00.09.05MediumOnly 3% of institutional long-term care claims have a primary diagnosis code.
Tennessee (TN)TN FFS experience9,815,24532.332.31.60Low 
Texas (TX)TX FFS Experience15,329,08141.412.71.46Low90% of institutional long-term care claims & 66% of other service file claims have a primary diagnosis code.
Utah (UT)No managed care SA coverage1,305,1630.00.06.77MediumSA is carved-out of MH managed care program, but may miss co-morbid services. Only 79% of other service file claims have a primary diagnosis code. MAX 2008 contains only claims adjudicated through Q1 FY 2009, thus expenditures may be incomplete.
Vermont (VT)No managed care SA coverage1,159,3360.00.025.99High 
Virginia (VA)VA FFS experience for disabled/Tier I &Tier II state experience for all others5,052,88545.545.53.67Low 
Washington (WA)Tier I & Tier II state experience5,909,882100.0100.024.33HighState-specific data for the disabled population was not used because expenditures for this population were substantially higher costs per enrolled month than averages for Tier I & Tier II high-supply states. Only 20% of institutional long-term care claims & 71% of other service file claims have a primary diagnosis code.
West Virginia (WV)WV FFS experience for full-benefit/Tier I & Tier II state for duals & partial-benefit.2,461,37819.22.29.31MediumDiagnosis codes are missing on most institutional long-term care claims.
Wisconsin (WI)WI FFS experience for disabled/Tier I & Tier II state experience for all others.6,565,02141.141.06.17LowMAX 2008 contains only claims adjudicated through Q3 FY 2009, thus expenditures may be incomplete.
Wyoming (WY)No managed care SA coverage358,6120.00.05.52High