Revolving Door for Addicts Adds to Medicaid Cost

New York has always been a treatment-rich state, spending more money on drug and alcohol treatment than any other state, including more than $300 million a year for drug detoxification services for 30,000 detox patients, according to today's New York Times.

What's shocking is the amount spent on "frequent fliers," individuals who check in and out of hospitals frequently over the course of the year. The state spends $50 million annually on its 500 most expensive patients - individuals who on average have more than a dozen detoxification episodes in a year.

As the article makes clear, the need for housing is a contributing factor for some of these frequent fliers, who find it easier to get hospital-based housing than going through the city's shelter system. It's also clear that some hospitals are failing to make an effective transition for their patients to longer-term treatment, in large part because of financial incentives that allow them to bill more for detoxification services than aftercare.


"[The data] suggests that New York City had a quarter of a millions homeless at some point in the previous half decade - which was a surprisingly high number. But only about twenty-five hundred were chronically homeless."

This is a quote from an article entitled "Million Dollar Murray" which was written by Malcolm Gladwell and published in the New Yorker.

You can read it here:

Published in 2006, the article explains how some problems such as homelessness, air pollution from auto emissions, and police misconduct would benefit from approaches that focus on the small number of hard cases instead of the the broad middle of the population.