What Is the Difference in Cost between Inpatient and Outpatient?
When a person struggles with addiction to drugs or alcohol, they need to get professional help, often from a rehabilitation program.
Since no one type of treatment is perfect for everyone, rehabilitation programs offer many treatment options. Clients typically attend therapy and counseling sessions, but in addition to these options, rehabilitation programs often offer yoga, nutritional help, mindfulness or meditation techniques, exercise coaches, acupuncture, case managers, maintenance medications, and other professional services.
With so many different options, costs of treatment can vary a great deal. Treatment programs are founded in either inpatient or outpatient care; either the person completely exits their existing environment and stays in an inpatient program for the duration of their rehabilitation, or they need or want to remain at home, so they attend an outpatient rehabilitation program. Ultimately, the choice to enter either type of treatment is very individual, and many insurance, government, and private financing options exist to help manage the costs. Still, cost can be a factor in the decision for many people, so it is important to understand the difference in treatment and cost between the two.
The Difference between Inpatient and Outpatient Treatment
Both types of treatment programs offer extensive therapy to help the individual understand their addiction and develop better coping mechanisms to reduce the risk of relapse in the future.
Inpatient and outpatient programs have different subsets that can help people with different needs, including different financial circumstances. Both inpatient and outpatient programs can last a minimum of 28 days, but longer treatment plans are advised as the National Institute on Drug Abuse (NIDA) recommends staying in a program for at least 90 days.
Both types of treatment should focus on counseling, or therapy, to develop skills and sobriety by:
- Learning to cope with drug cravings
- Learning strategies to avoid drugs or alcohol
- Developing a relapse plan in case of a lapse or relapse
- Discussing personal issues, such as employment, family or friend relationships, legal issues, etc.
- Involving friends or family in recovery, often via family therapy
- Learning from peers, often in group therapy
Inpatient treatment programs are also known as residential treatment. This is a great option for people who need consistent medical help to safely detox, especially from substances like alcohol, benzodiazepines, and opioids, which can require intense medical supervision and maintenance medications to ensure the person is safe and does not relapse during withdrawal. Some inpatient rehabilitation programs do not offer medical detox but accept patients once they have detoxed.
The greatest benefit of residential treatment programs is that the individual is removed from their original environment. For people who live in a stressful home or are around many people who may influence whether they ingest drugs or alcohol, being removed from these triggers can help the person to focus on their recovery. Additionally, the individual is surrounded by peers who are also going through treatment for substance abuse; they can create a new community of friends who all support each other on the road to sobriety.
Other benefits of a residential program include access to medical professionals, therapists, and specialty programs, like meditation or nutrition options, that are geared specifically to overcoming substance abuse problems.Outpatient rehabilitation is a good option for people who want to maintain at least part-time employment while they go through treatment or who cannot afford to take a long leave of absence from their job. People who have supportive friends and family can benefit from outpatient programs because their home environment will encourage them to remain in treatment. People with young children, or who are attending school themselves, may also find outpatient programs ideal for their situations.
While outpatient programs also focus on a specific number of therapy sessions to help the person overcome their addiction, these programs often do not offer as much support from other professionals, such as coaches, spiritual leaders, case managers, or exercise therapists. Increasingly, physicians can provide prescription maintenance medications, like buprenorphine, to people who are part of an outpatient treatment program; however, there is much less medical supervision for taking these prescriptions compared to an inpatient program. It is very important that a person entering an outpatient program has social support from friends and family, so their time outside of treatment is safe and encouraging.
Often, people who have financial concerns may choose an outpatient program specifically because these programs are less expensive. They are also at least partially covered by private insurance, government programs like veterans benefits, and outside sources of funding, like specific grants or scholarships.
Cost Breakdown: Inpatient Treatmen
The cost of rehabilitation programs varies widely by state and specific resources provided by the program. Factors that play a role in overall cost adjustments, as well as the types of financial assistance accepted by the facility, include:
- Types of treatment offered
- Types of clients accepted (general population versus wealthier individuals)
- Amenities at the facility
- Location of the facility (programs in large cities are often more expensive)
- Length of stay in the program and level of intensity of care
For people with low income levels who need an inpatient program, a 30-day stay can cost as little as $5,000, and this cost does not include insurance coverage or government assistance. However, the average cost nationwide for inpatient treatment is $30,000 per month. Insurance, Medicare, Medicaid, and fundraising efforts may reduce this amount. In addition, rehabilitation programs may be willing to offer payment plans where clients can pay the balance of care over a longer period of time, making treatment more financially manageable.
If the program offers detox, then that cost can increase the overall cost of residential treatment. Detox supervision and medications may cost an average of $250 per day, separate from any other daily costs. Individuals who are maintained on long-term maintenance medications, such as buprenorphine, need to take these costs into account.
Luxury rehabilitation programs can cost significantly more than standard facilities, due to the extensive amenities and high level of care provided, and government aid will generally not cover the cost of these programs. While these options offer many more amenities, including acupuncture, massage, yoga, gourmet meals, luxury accommodations, pools and spas, and other methods of relaxation that could be beneficial for many people, most of these services are considered extravagant and not medically necessary or helpful. The focus of the average inpatient rehabilitation program is on helping the person via therapy.
Regardless of the specific facility chosen, inpatient treatment is always more expensive than outpatient treatment due to the associated costs of room, board, and 24-hour care.
Cost Breakdown: Outpatient Treatment
As with inpatient programs, outpatient programs focus on understanding the addiction, the potential triggers of the addiction, and forming new ways to manage cravings or stress. Clients in outpatient treatment programs can put the lessons learned in therapy into immediate practice in their daily life outside of the treatment facility. Some programs, like intensive outpatient programs, may feel more like inpatient programs because the person spends a full day in therapy sessions, but ultimately, they return home in the evening.
The average outpatient program cost is approximately $1,400 for a 30-day program or $2,000 for a 60-day program, although those costs increase rapidly if medication, medical supervision, case management, or other non-therapy services are part of the program. The Center for Substance Abuse Treatment (CSAT) reported that costs in 2006 for non-methadone outpatient treatment ranged from $1,000 to $5,000, or a weekly cost of $19-$96 per week, per patient. Naturally, as the value of the dollar changes, the cost of treatment will adjust.
As with inpatient treatment, some outpatient treatment programs offer more comprehensive care and additional amenities and services. Prices will scale accordingly, and some outpatient treatment programs can cost upwards of $10,000 per month.
Cost Should Not Stand in the Way of Treatment
Ultimately , cost should not be the primary factor in deciding which type of treatment is most appropriate. People who have co-occurring disorders, such as addiction and bipolar disorder or schizophrenia, will benefit more from the structure of inpatient treatment; people who have very supportive family members and a stable job may benefit more from outpatient treatment.
The cost of outpatient treatment is much lower than inpatient treatment, but the program does not offer as much assistance overall. Both types of treatment can be covered, at least in part, by insurance or government assistance.
People who need help with financing can ask a representative at the specific treatment facility about payment options. Most facilities are willing to work with clients to make paying for treatment more manageable. Additionally, friends, family, or a case manager or social worker can help prospective clients to find financial resources, so the person can get help from a program as soon as possible.