"If you can offer people a treatment option and give them a structure for prolonged recovery, that's going to be more cost-effective than if you treat people as they show up in the ED," he says. "But remember that there is a lot of relapse in addiction treatment—because it's a hard thing to treat. We try to pull out everything in our arsenal to help somebody in their recovery, because ultimately it's a lot cheaper to treat somebody in a behavioral health setting than in an ED setting."
The cost saving isn't limited to payers and providers, notes Teas. "According to government statistics, for every dollar you spend on addiction treatment of people who get into the criminal justice system, you save $5–$7 for the taxpayer."
What's more, up to 40% of all patients in acute care hospitals, if carefully inspected, would meet diagnostic criteria for an alcohol use disorder, Teas says. "By not identifying and treating these individuals, you're going to see recidivism and increased organ system disease that will only mount medical costs in the future."
"For every dollar you spend on addiction treatment of people who get into the criminal justice system, you save $5–$7 for the taxpayer."
Success key No. 3: Watch for recidivism
While a degree of relapse is inevitable, lower recidivism rates are a key indicator of service line success, says Ciha. "You definitely want to look at your EDs and see how many patients come in again for drug-related detox or drug-seeking behavior and then try to engage them in long-term recovery that will decrease the need for episodic inpatient treatment."
At St. Mary's, leaders will be watching those metrics, as well as overdose rates, to gauge the success of their recovery coach pilot. "The most powerful question will be whether we're able to get [patients] to their own homes and maintain a recovery program so they don't have to come back to the ED."
One way to curb the revolving-door effect is to use the time substance-addicted patients do spend in hospitals more productively, says Teas. "A lot of detoxification throughout our country is done in medical units without any behavioral health component. A lot of these individuals are simply lying in bed watching TV and not receiving any programming related to recovery."
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.