In his article Drug dependence, a chronic medical illness; Implications for treatment, insurance and outcomes evaluation. Dr. McLellan explains in the Journal of American Medical Association 284(13):16889-1685 the following.
“The traditional model of treating addiction has encouraged people to assume that patients entering treatment should be able to maintain lifelong abstinence following a single period of specialized treatment. Accordingly, policy makers allocate limited public health dollars for addiction rehab; insurers restrict the number of patient days and visits covered; treatment or rehab centers make no infrastructure allowance for ongoing monitoring; and families and the public become impatient and/or totally discouraged with patient relapses”.
It is clear, that the policy makers and the insurance systems are failing.
The typical addiction treatment model perpetuated by policy makers and insurance companies is built around admitting an addicted individual into an outpatient program, then requiring them to fail 2 to 3 times before obtaining an approval for a residential rehabilitation program. If approved for residential rehab, the typical stay dictated by the insurance company is 15 to 30 days. Insurance companies rarely pay or reimburse for anything longer.
Treatment facilities that are dependent on insurance provider dollars for their operational needs build their programs around the 15 to 30 day coverage, instead of building around what the individual needs. According to the National Institute of Drug Abuse, research shows that an addicted person needs about 90 days in residential rehab for the best chance of a lasting recovery. This allows time for their brain chemistry to “reboot” and develop the tools it takes to sustain long-term success. In addition, a lasting recovery may involve on-going outpatient behavioral therapy and social support after the residential stay is complete.
The time it takes to successfully break the cycle of alcohol or drug abuse and begin to heal the brain and the body is not aligned with insurance companies’ treatment model expectations. In fact, the current insurance model actually impairs a treatment facility’s ability to help addicted individuals long-term. This is just one of the reasons addicted patients are in and out of treatment so many times, over the course of their lives. They have been set up to fail by the system that is treating them based on what the insurance company will reimburse for care.
For this reason, HUGS Recovery, is a private-pay facility. We have created long-term programs based on scientific evidence because – we are here to help our clients break their cycle of addiction and experience long-term recovery. Give us a call today at 888-874-0593.
Contact our admissions office today at 1-888-874-0593 or click the “Reserve My Bed” button to reserve a bed today!
HUGS Recovery 777 Cleveland Ave., Suite 301, Atlanta, GA 30315 404-228-2222