Maryland Better Chance Project: A Clinical Trial of Two Innovative OutreachStrategies for Pregnant Substance Abusers

摘要

The Maryland demonstration was one of five states in a multi-year award that wasdirected to increase the number of Medicaid-eligible pregnant substance abusers who received coordinated perinatal care services, substance abuse treatment, and other relevant direct services for improving the health status of both mothers and their newborns. The Maryland project did not require state waivers. As Medicaid recipients, the project participants received target case management services under the provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985. The demonstration was designed in part to test methods of service delivery which were more likely be used by this high risk population. The demonstration found that the combination of case management in conjunction with support groups and comprehensive prenatal and drug treatment services was a more cost-effective outreach strategy than support groups alone, or than with support groups with comprehensive and drug treatment services group showed the greatest reduction in cocaine use and/or heroin use, as compared with the other two groups. The case management 'plus' group was a cost-effective intervention to reduce Medicaid expenditures.