Table 3.

Multilevel Model Findings on Facilities' Adoption of Naltrexone

Dependent Variable: Facility Adopted Naltrexone as Pharmacotherapy
	Model 1 (N1=13,290)			Model 2 (N1=12,439, N2=47)
Independent Variables	Coefficients	Standard Error	p- Value	Coefficients	Standard Error	p- Value
Facility-level variables
Intercept	−2.596	0.158	<.0001	−2.616	1.404	.073
Primary focus: general health care	0.949	0.311	.002	1.008	0.328	.002
Primary focus: mental health services	0.306	0.117	.009	0.428	0.121	.000
Primary focus: SATX/mental health mix	0.931	0.164	<.0001	0.924	0.173	<.0001
Primary focus: not SATX/MH/mix	−0.524	0.309	.090	−0.590	0.326	.071
Affiliation w/hospital	0.778	0.093	<.0001	0.811	0.096	<.0001
Hospital in-patient SATX	0.516	0.101	<.0001	0.465	0.106	<.0001
No out-patient SATX	−0.452	0.099	<.0001	−0.477	0.103	<.0001
Nonhospital residential SATX	0.238	0.084	.004	0.242	0.087	.005
No relapse prevention groups	−0.626	0.089	<.0001	−0.612	0.092	<.0001
No aftercare counseling	−0.227	0.082	.006	−0.251	0.084	.003
No individual therapy	−0.453	0.151	.003	−0.448	0.155	.004
No case management services	−0.167	0.069	.016	−0.197	0.071	.006
No comprehensive SA assess/diagnosis	−0.332	0.153	.029	−0.368	0.160	.021
No other social service assistance	0.004	0.072	.951	0.021	0.074	.775
Offers employment counseling and/or housing assistance	0.329	0.069	<.0001	0.344	0.071	<.0001
Accredited by JCAHO	0.622	0.078	<.0001	0.637	0.079	<.0001
For-profit	−0.242	0.103	.019	−0.250	0.106	.018
Nonprofit	−0.646	0.083	<.0001	−0.651	0.086	<.0001
Does not accept state-financed health insurance	−0.183	0.072	.011	−0.201	0.074	.007
Does not accept Medicaid	0.104	0.078	.180	0.143	0.080	.073
Contracts w/MCOs for SATX	0.556	0.067	<.0001	0.551	0.069	<.0001
Does not use sliding fee scale	0.240	0.067	.000	0.262	0.069	.000
No fed/state/cty/local earmark funds	0.288	0.071	<.0001	0.289	0.073	<.0001
Licensed by mental health Department	0.237	0.072	.001	0.233	0.074	.002
Licensed by state SA agency	−0.401	0.082	<.0001	−0.387	0.084	<.0001
% of clients treated for alcohol abuse	0.005	0.001	.000	0.005	0.001	.001
Operates an opioid treatment program	0.264	0.106	.013	0.230	0.108	.033
State-level Medicaid/managed care policies
Medicaid benefits for rehab—SA limitations				−0.178	0.078	.031
Medicaid policy: generics on PDL/formulary				0.365	0.115	.004
State permits MCO/PCCM to set policies encouraging generics				0.671	0.201	.003
Medicaid policy: state preferred drug list				−0.241	0.118	.050
State permits MCO/PCCM to set policies restricting access to pharm network				−0.647	0.175	.001
Capitated/MCO delivers Medicaid benefits				0.568	0.194	.007
Medicaid policy: MCO delivers Rx				−0.665	0.202	.003
Medicaid policy: lower generic copays				0.122	0.120	.315
Medicaid policy: generic rate paid for brand				0.044	0.104	.678
State-level capacity/financing and environment
Federal Medicaid assistance % (2002)				0.010	0.011	.378
State discretionary funding for substance abuse treatment (per capita)				−0.007	0.029	.821
State public welfare expenditures per capita				0.690	0.232	.006
State health care expenditures per capita				−2.359	1.139	.048
% counties w/no MH professional shortage				0.013	0.003	<.0001
% counties w/no primary care physician shortage				−0.008	0.003	.012
State population median age				−0.048	0.033	.159
% ages 26+ w/alcohol abuse/dependence				0.189	0.063	.006
% of state population in poverty, 2002–2004 average				−0.040	0.023	.089
State government ideology index				−0.004	0.002	.104
Goodness of fit: −2 residual log likelihood	72,649.3			68,169.9

MCO, managed care organization; PCCM, primary care case management; SATX, substance abuse treatment.