New Report: Prison Health Care Costs and Quality
Date:  10-26-2017

How and why states strive for high-performing systems
From Pew Charitable Trusts:


Prison health care sits at the intersection of pressing state priorities. From protecting public safety to fighting disease and promoting physical and behavioral health, and from fine-tuning budgets that trim waste to investing in cost-effective programming with long-term payoffs, the health care that prisons provide to incarcerated individuals and the care that prisons facilitate post-release is a critical linchpin with far-reaching implications.

On a typical day, state prisons house more than a million people, many of whom have extensive and communicable health ailments. The manner in which services are provided affects state budgets because of the expensive treatments for some common conditions, the downstream costs of delayed or inadequate care, and the legal and financial consequences of being found to violate inmates’ constitutional rights to “reasonably adequate” care. Moreover, with nearly all incarcerated individuals eventually returning to society, treatment and discharge planning—especially for those with a substance use disorder, mental illness, or infectious disease—play an important role in statewide anti-recidivism and public health efforts. Taken together, these realities call for the attention of policymakers and administrators.

Yet these officials often lack the information they require to build and maintain high-performing prison health care systems that proactively make the most of diagnostic and treatment opportunities and avert the harmful and expensive consequences of inattention or missteps. They need to know how much money is being spent on what services and why; what benefits are achieved for those dollars; and whether these benefits are preserved post-prison through well-coordinated prison-to-community transitions. This first-of-its-kind report, using data collected from two 50-state surveys administered by The Pew Charitable Trusts and the Vera Institute of Justice, along with interviews with more than 75 state officials, updates previous Pew research on spending trends in prison health care. The report also incorporates information on the operational characteristics of states’ prison health care systems; whether and how states monitor the quality of care provided— the critical counterpart to cost when assessing value; and common care continuity strategies for people leaving prison. The aim is to begin to paint a comprehensive picture for policymakers, administrators, and other stakeholders of how states fund and deliver prison health care, how they compare with one another, and some reasons for differences. These stakeholders can use such practical information and insights to help optimize policies and programs in the service of incarcerated individuals, state residents, and taxpayers.

The first of the two surveys, for which every state except New Hampshire provided data, queried senior budget staff of state departments of correction on expenditures, prison population demographics, the health care delivery system employed, and staffing. The second survey, for which every state except Alabama, Kansas, and New Hampshire provided data, collected information from senior health care staff of departments of correction on efforts to monitor the quality of care provided, disease prevalence tracking, and services to facilitate care continuity at release.

Read the full report here.