Category: Dissemination / Implementation

Symposium

Incremental Costs Associated With Evidence-Based Treatments for Youth in Community-Based Behavioral Health

Friday, November 17
10:15 AM - 11:45 AM
Location: Indigo Ballroom A, Level 2, Indigo Level

Keywords: Implementation | Health Care System | Public Policy
Presentation Type: Symposium

Evidence-based treatments (EBTs) hold significant promise to address the public health and economic impact of childhood behavioral health disorders (e.g., Lee et al., 2014), and jurisdictions are increasingly mandating use of these treatments in community behavioral health agencies. Agency directors have expressed concerns about the expense and burden associated with mandated EBT implementation (Proctor et al., 2007), but it is difficult to predict the impact of such policies because limited data are available on implementation costs. This presentation will report findings from an online survey of EBT implementation costs that surveyed administrators from 12 geographically diverse agencies. Each participant selected up to three EBTs and reported associated costs in five categories: 1) personnel, 2) facilities and administration, 3) finances (e.g., grant support), 4) training (initial and ongoing), and 5) EBT-specific expenses (e.g., standardized measures). Technical assistance was available throughout survey participation. Agencies received personalized reports of their cost estimates as a validity check prior to aggregation across agencies. Overall, participants reported implementation costs for 11 youth-focused EBT models; the average weighted incremental costs were $114 for general outpatient EBTs and $1548 for intensive outpatient EBTs. We also separated costs by implementation stages, based on the National Implementation Research Network framework (i.e., planning, installation, implementation, operation, innovation, and sustainability), and by start-up versus recurrent. Notably, per-client costs were negatively associated with the number of clients served, illustrating that greater economies of scale are achieved with increasing implementation. In conclusion, the incremental costs associated with EBTs were modest, but also immediate, whereas economic benefits are often delayed and accrue within other systems (e.g., medical, child welfare). These findings highlight the importance of considering financial support for community behavioral health agencies as part of policies that mandate use of EBTs with youth and families.

Suzanne Kerns

Research Associate Professor
University of Denver

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