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Cited by 33Crime Patterns and InterventionsHealth Policy Implementation ScienceChild Welfare and Adoption

Economic Impact of the Statewide Implementation of an Evidence-Based Treatment: Multisystemic Therapy in New Mexico

Dopp, Alex R., Coen, Anita Saranga, Smith, Allison B., Reno, Jessica, Bernstein, David H., Kerns, Suzanne E.U., Altschul, Deborah·2018·Behavior Therapy
DOI 10.1016/j.beth.2017.12.003
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Abstract

Several states have made considerable investments into large-scale implementation of evidence-based treatments (EBTs), yet little is known about key success indicators for these implementation efforts such as cost and sustainability. To that end, the present study examined the economic impact of statewide implementation of multisystemic therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cuningham, 2009), a family- and community-based behavioral EBT for serious juvenile offenders in New Mexico. Participants were 1,869 youth who received MST across 23 teams during the study period. We conducted a cost-benefit analysis using metrics from state data sources that compared the cost of MST to its benefits (i.e., avoided expenses from pre- to posttreatment) in two domains: (a) behavioral health services (i.e., Medicaid claims) and (b) 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 was intended to cover expenses for both clinical and implementation (e.g., training, quality assurance) activities. Results suggest that implementation of MST in New Mexico over the 7-year study period may have produced net benefits, through 2 years posttreatment, of more than $4,643 per youth in avoided behavioral health claims and $15,019 per youth through reductions in juvenile crime. Stated differently, every dollar that New Mexico spent on MST appeared to have returned $3.34 for a total benefit of $64.2 million over the course of the study. We discuss implications of these findings for policymakers, administrators, and researchers who are interested in increasing the sustainability of complex EBTs in community settings.

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  • Community-based behavioral health agencies that deliver MST pay up-front for implementation, often with support from juvenile justice partners, whereas Medicaid and adult criminal justice realize most of the eventual benefits from decreased arrests and out-of-home placements.

    “For example, community-based behavioral health agencies that deliver MST pay up-front for implementation, often with support from juvenile justice partners, whereas Medicaid and adult criminal justice realize most of the eventual benefits from decreased arrests and out-of-home placements [36].”

    From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [36]

  • Economic evaluations estimate that MST produces over $3 in economic benefits per $1 spent within 2 years post-treatment.

    “Finally, economic evaluations estimate that MST produces over $3 in economic benefits per $1 spent within 2 years post-treatment [36, 37].”

    From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [36]

  • Based on published evidence of >$3 for each dollar spent and the state's predicted 28% reduction in youth recidivism, state-level savings for this initiative were conservatively predicted at over $8 million across 3 years.

    “Based on published evidence of >$3 for each dollar spent [36, 37] and the state’s predicted 28% reduction in youth recidivism [39], state-level savings for this initiative were conservatively predicted at over $8 million across 3 years.”

    From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [36]

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Authors
Dopp, A. R., Coen, A. S., Smith, A. B., Reno, J., Bernstein, D. H., Kerns, S. E. U., & Altschul, D.
Affiliations
  • University of Arkansas at Fayetteville (US)
  • University of New Mexico Health Sciences Center (US)
  • University of Denver (US)
Corresponding author
Dopp, Alex R.
ORCID
Venue
Behavior Therapy
Publisher
Elsevier BV
Published
2018-07
Volume
49
Issue
4
Pages
551-566
ISSN
0005-7894 (ISSN-L)
DOI
10.1016/j.beth.2017.12.003
OpenAlex
W2773136167
Cited by
33
References
42
Citations by year
2026: 5 · 2025: 1 · 2024: 5 · 2023: 1 · 2022: 5 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 2
FWCI
6.98
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Behavior Therapy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Sociology and Political Science › Crime Patterns and Interventions
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Social Sciences › Safety Research › Child Welfare and Adoption
Keywords
multisystemic therapy, evidence-based treatment, statewide implementation, juvenile offenders, cost-benefit analysis, Medicaid claims, juvenile delinquency, treatment sustainability, New Mexico
MeSH terms
Adolescent, Combined Modality Therapy, Cost-Benefit Analysis, Crime, Female, Humans, Juvenile Delinquency, Male, New Mexico, Psychotherapy, Evidence-Based Medicine, Crime Victims

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