Patient Centered Assessment and Substance Use Disorder Treatment Study (PCAST)

NCT ID: NCT03486028

Last Updated: 2019-11-26

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 991 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2018-07-31
• Study Completion Date: 2019-10-27

Brief Summary

California counties are in the process of implementing a Centers for Medicare and Medicaid Services Medicaid 1115 Substance Use Disorder (SUD) demonstration. The demonstration requires that patients be assigned to addiction treatment settings and levels of care systematically, using comprehensive biopsychosocial assessments and guided by the American Society of Addiction Medicine (ASAM) patient placement criteria.

RTI International, a nonprofit research institute, and University of California Los Angeles (UCLA) Integrated Substance Abuse Programs have been awarded a contract from the Patient Centered Outcomes Research Institute (PCORI) to study the effects of the ASAM implementation in California. The California 1115 SUD demonstration provides a unique opportunity to learn about the benefits and challenges resulting from system-wide implementation of ASAM criteria.

The study will involve surveying patients in counties that are using the ASAM criteria and in counties that have not yet adopted the ASAM criteria. Medicaid patients receiving addiction treatment will be offered the opportunity participate in the study and to be surveyed about their experiences in treatment. The study will also analyze data from the California Outcomes Management System (CalOMS) and conduct interviews with providers, patients, and policymakers in the state. The results of the study will help inform California's efforts to continually improve its addiction treatment systems to better meet the needs of it communities. This study will also produce important and useful information to patients seeking treatment for addiction, and their providers, SUD system administrators, and payers.

Conditions

Substance Use Disorders

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: OTHER

Study Groups

ASAM Counties/non-computerized

Pre- and 1115-waived counties that are implementing the ASAM. Intervention is adherence to ASAM protocols.

Adherence to ASAM protocols

Intervention Type: OTHER

ASAM Counties. These counties are requiring their providers to use ASAM criteria to assess patients and to determine level of care. These counties also use ASAM to determine the ongoing need for high-intensity services, such as residential, and approve those services for Medicaid payment.

ASAM Counties/computerized

Counties using a computerized system to assist in intervention determination according to ASAM protocols. Intervention is adherence to ASAM protocols.

Adherence to ASAM protocols

Intervention Type: OTHER

ASAM Counties. These counties are requiring their providers to use ASAM criteria to assess patients and to determine level of care. These counties also use ASAM to determine the ongoing need for high-intensity services, such as residential, and approve those services for Medicaid payment.

Non-ASAM Counties

Pre- and non-waived "control" counties that are not implementing the ASAM. Intervention is non-adherence to ASAM protocols.

Non-adherence to ASAM protocols

Intervention Type: OTHER

These counties are not implementing the ASAM criteria to assess patients and determine the level of care.

Interventions

Adherence to ASAM protocols

ASAM Counties. These counties are requiring their providers to use ASAM criteria to assess patients and to determine level of care. These counties also use ASAM to determine the ongoing need for high-intensity services, such as residential, and approve those services for Medicaid payment.

Intervention Type: OTHER

Non-adherence to ASAM protocols

These counties are not implementing the ASAM criteria to assess patients and determine the level of care.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Individuals age 19 or older
• Receiving treatment for addiction in specialty addiction treatment programs licensed in California who are Medicaid beneficiaries.

Exclusion Criteria

• Less than 19 years old
• Not receiving treatment for addiction in specialty addiction treatment programs licensed in California
• Not Medicaid beneficiaries

• Minimum Eligible Age: 19 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of California Integrated Substance Abuse Programs

UNKNOWN

Sponsor Role: collaborator

Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role: collaborator

RTI International

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Tami Mark, PhD, MBA

Role: PRINCIPAL_INVESTIGATOR

RTI International

Locations

RTI International

Research Triangle Park, North Carolina, United States

Countries

United States

Other Identifiers

0216289

Identifier Type: -

Identifier Source: org_study_id