The U.S. Addiction Rehab Industry - 5th Edition

Table of Contents

Introduction, Sources & Methodology Used
 
Executive Overview of Major Findings

Discussion of scope of U.S. alcohol and drug addiction problem, cost to society, impact of treatment, structure of treatment providers industry (no. of facilities by type), major industry trends and issue, industry size, growth and forecasts (1983-2025 F), effects of recessions and Affordable Care Act, outlook for 2020, list of leading treatment organizations/companies, user demographic highlights of 2019 SAMSHA government survey regarding scope of drug & alcohol abuse/usage/persons in treatment, client & facility characteristics - highlights of all report chapters.

Nature and Structure of the Industry

• Discussion of different types of centers (% for-profit, non-profit, private/government, by primary focus), typical programs offered, treatment programs by type site
• Discussion of indicators of program quality
• Inpatient vs. outpatient care, etc. (no. of facilities, patients served, occupancy rate, industry revenues, average revenues per facility, mean no. of clients per facility,
• Typical cost of rehab
• Demand for care: no. of persons that need treatment
• Discussion of the industry’s major problems and scandals (deceptive marketing, overbilling, patient brokering, fraud, etc.)
• Various types of rehab (drug, alcohol, sex addiction, gambling, Internet, post-traumatic stress),
• The 6 major types of rehab (philosophies – faith-based, evidence-based, 12-step, etc.)
• Tables
  • Number of clients served, by type facility: 2012 vs. 1998
  
  

Demographics -SAMHSA Survey Findings - Data on Substance Abusers

• Key statistics about national costs of drug & alcohol abuse, hospitalizations, opioid use
• Discussion of trends in illicit drug use, persons age 12 or older: (usage of marijuana, cocaine, heroin, hallucinogens, methamphetamine, nonmedical use of prescription drugs – number and percent of persons)
• Discuss trends in alcohol use, persons age 12 or older: (heavy drinking, binge drinking, current use – number and % of persons)
• Marijuana use – discussion, number and % of persons
• Cocaine use – discussion, number and % of persons
• Heroin use – discussion, number and % of persons
• Methamphetamine use – discussion, number and % of persons
• Inhalants use – discussion, number and % of persons:
• Hallucinogens use – discussion, number and % of persons:
• Psychotherapeutics use – discussion, number and % of persons:
• The Opioid epidemic: discussion, number and % of persons
• Tables, Charts
  • Past month Total substance abuse funding by National Institutes for Health 2013-2020 2018 National Survey on Drug Use and Health: Major Findings:
  • Past Month Substance Use among People Aged 12 or Older: 2018
  • Current, Binge, and Heavy Alcohol Use among People Aged 12 or Older: 2018
  • Past Year Illicit Drug Use among People Aged 12 or Older: 2018
  • Past Year Marijuana Use among People Aged 12 or Older: 2002-2018
  • Past Year Cocaine Use among People Aged 12 or Older: 2002-2018
  • Past Year Heroin Use among People Aged 12 or Older: 2002-2018
  • Past Year Methamphetamine Use among People Aged 12 or Older: 2015-2018
  • Past Year Prescription Tranquilizer or Sedative Misuse among People Aged 12 or Older: 2015-2018
  • Past Year Prescription Benzodiazepine Misuse among People Aged 12 or Older: 2015-2018
  • Past Year Prescription Pain Reliever Misuse among People Aged 12 or Older: 2015-2018
  • Past Year Prescription Pain Reliever Misuse among People Aged 12 or Older, by Selected Pai Reliever Subtype: 2018
  • Source Where Pain Relievers Were Obtained for Most Recent Misuse among People Aged 12 or Older Who Misused Pain Relievers in the Past Year: 2018
  • Past Year Opioid Misuse among People Aged 12 or Older: 2018
  
  

Major Industry Trends & Issues

• Discussion of insurance fraud and overbilling, patient brokering, deceptive marketing
• Discussion of The Affordable Care Act and the Mental Health Parity and Addiction Equity
• Act and how it has upended the industry’s business model
• Compliance with evidence-based practices is spotty
• Private equity investors pour money into addiction treatment
• Attempts at reform: actions by Google, The Federal Support Act
• Discussion of The Opioid Crisis & Treatment, medically assisted treatment.

Industry Size, Growth, Segments, Forecasts

• Summary: Total industry size, estimates by government vs. other mkt. research firms, public vs. private spending/funding
• The treatment population: no. and % of people actually receiving treatment: 2018, payment by source of funds
• Number of treatment facilities in U.S., % treated by type facility, median no. of clients (total and by outpatient, residential, hospital, detox)
• Estimates of industry size ($ revenues): 2019 SAMHSA report, growth of private, public, out-of-pocket spending 2020 outlook and effect of Affordable Care Act, projected increase of persons in treatment, effects of recessions
• 2025 Forecast: major trends discussion: reliance on public financing, Medicaid, increased private insurance coverage, E-health, effect of recessions
• Discussion of Medicaid and Other State and Local Financing.
• The high-end market segment: discussion of the private pay marketplace, $ value
• Destination markets: discussion of the South Florida market, the “Florida Model”, history
• Discussion of the gambling addiction market: no. of problem gamblers, amount spent per year
• Sex addiction: discussion of why it has come into the mainstream, Tiger Woods and other celebrity publicity, types of treatment programs, list of top treatment centers.
• Tables
  • Number of substance abuse treatment facilities in the U.S. - 2005-2018
  • Substance abuse treatment expenditures: amount, percent distribution, avg. annual growth: 1986-2020
  • Substance Abuse Expenditures, by Type Facility: selected years: 200-2020
  • Substance Abuse Expenditures, by type payment: selected years: 2010-2020
  • Historical Federal Drug Control Spending on Treatment & Prevention, by fiscal year: 2003-2020
  • Historical estimates of the industry’s size, rational: 1983-1998
  
  

Treatment Facility Operating Ratios

• U.S. Census Bureau ratios for mental health & substance abuse facilities (2017, 2012, 2007) – no. of facilities, revenues, avg. revenues per center, payroll costs, no. of employees (outpatient vs. inpatient centers) - summary
• Discussion of no. of clients per facility, mean cost of care, cost to treat per person, outpatient care
• Tables
  • Key economic ratios, Census data
  • Number of substance abuse treatment facilities in the U.S. by state: 2018
  • Growth in Number of substance abuse treatment facilities in the U.S. 2005-2018
  • Facility Operation and Primary Focus
  • Distribution of Substance abuse treatment facilities in the U.S. as of 2018, by type of care offered
  • Estimated Number of Clients Served, by Type Facility: 2018 vs. 2012
  
  

Competitor Profiles of the Leading Treatment Organizations and Multi-Center Chains
(For each organization, a discussion of: history/founding, description of major programs, services, estimated/actual revenues, no. of centers, fees, facilities operated, mergers, sold facilities, recent developments.)

• Hazelden Betty Ford Foundation
• CRC Health Group
• American Addiction Centers
• Promises Behavioral Health
• Passage Malibu
• The Caron Foundation
• Comprehensive Care Corp.
• Malibu Horizon Rehab Center
• Behavioral Health of The Palm Beaches

Directory of Industry Reference Sources

• Name/address/phone of drug & alcohol abuse-related industry trade associations, government reports, major EAP industry trade journals, hotline phone numbers, etc.
• List of state substance abuse agencies

Companies Mentioned

• Hazelden Betty Ford Foundation
• CRC Health Group
• American Addiction Centers
• Promises Behavioral Health
• Passage Malibu
• The Caron Foundation
• Comprehensive Care Corp.
• Malibu Horizon Rehab Center
• Behavioral Health of The Palm Beaches

Methodology