Patient Placement Criteria: Linking Typologies to Managed Care

The proliferation of managed health care systems as a means of controlling rising health care costs has stimulated efforts to subdivide the heterogeneous population of alcoholics into more homogeneous subgroups based on their needs for specific levels of treatment. The American Society of Addiction Medicine (ASAM) has developed a set of criteria aimed at helping clinicians select from four levels of care the one most appropriate for each patient. The ASAM criteria are designed around six criteria dimensions reflecting the severity of the patients alcohol-related problems. Although the ASAM criteria currently are the most widely used placement criteria for alcoholism treatment and reimbursement, they also have been criticized in several respects. Moreover, they still require outcome validation to ensure that application of the criteria improves treatment outcome.