Category: Dissemination / Implementation
Keywords: Implementation | Criminal Justice | Public Policy
Presentation Type: Symposium
Certain states have made considerable investments into large-scale implementation of evidence-based treatments (EBTs) to reduce juvenile delinquency. Unfortunately, little is known about key success indictors for these implementation efforts such as cost and sustainability. This presentation will discuss findings from a study that examined the economic impact of the first seven years (July 2005 through June 2012) of statewide implementation of multisystemic therapy (MST), a family- and community-based behavioral EBT for serious juvenile offenders, in New Mexico. Participants were 1,869 youth who received MST from one of 23 teams (administered by 10 provider organizations) during the study period. We conducted a cost-benefit analysis, using metrics from state databases, that compared the cost of MST to its benefits (i.e., avoided expenses) in two domains: (a) Medicaid claims for other behavioral health services and (b) the financial consequences of juvenile crime (i.e., taxpayer expenses, tangible and intangible expenses to crime victims). MST costs were based on Medicaid claims, which were reimbursed at an enhanced billing rate that covered both clinical and implementation (e.g., training, quality assurance) expenses. Results suggest that implementation of MST was associated with net benefits, through two years posttreatment, of more than $4,643 per youth in avoided behavioral health claims and $51,106 per youth through reductions in juvenile crime. Stated differently, every dollar that New Mexico spent on MST over the seven-year study period returned $5.80, for a total benefit of $139.7 million. Thus, the benefits of MST exceeded the costs of the treatment and of related implementation activities. We will discuss implications of these findings for policymakers, administrators, and researchers who are interested in increasing the cost and sustainability of behavioral EBTs for juvenile offenders. This study represents the first economic analysis of an MST statewide implementation project and, to our knowledge, the most comprehensive economic analysis for implementation of any youth-focused EBT.
University of Arkansas
Friday, November 17
10:15 AM – 11:45 AM
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