Headline
Data from an ongoing clinical trial is used to estimate the cost of implementing a contingency management program and develop a customizable budget impact tool.
Context
Contingency management interventions are designed to promote behavior change related to substance use or engagement in treatment by offering patients tangible incentives, such as gift cards. There is promising evidence that contingency management is effective at improving outcomes for people with substance use disorder (SUD), including reduced substance use. This article describes data used to inform a publicly available and customizable contingency management budget impact tool.
Findings
Drawing from an ongoing clinical trial on the effectiveness of contingency management programs, this study found that the average cost of a 16-week program serving people with co-occurring serious mental illness and severe alcohol use disorder to be between $1,100-$1,900 per participant. Per-participant costs varied based on the size of the incentive being offered, with participants entered into a gift card drawing each time they submitted a urine sample that reflected alcohol abstinence or reduced consumption. Fixed start-up costs totaled approximately $6,000, including office equipment and staff time for training.
Takeaways
Although states are beginning to receive federal approval to offer contingency management under Medicaid, it remains an underutilized approach to serving people with SUD. Providers interested in establishing or enhancing contingency management programs should consider using the budget impact tool published alongside this article to estimate up-front and ongoing costs associated with implementing contingency management programs.