Prison health care: Can states improve outcomes while managing costs?

By , November 8, 2013

Last week, the Pew Charitable Trusts’ State Health Care Spending Project published a new report, Managing Prison Health Care Spending. The paper discusses practices that have important cost-benefit implications, such as these:

  • Telehealth. By using electronic communications and information technology in clinical care, this approach doesn’t just control costs, but in some states delivers “better, cheaper care” to inmates. Texas officials say that telehealth and other practices led to positive health outcomes for incarcerated adults, including lower average blood-sugar rates, improved blood-pressure readings, and fewer AIDS-related deaths.
  • Partnerships with universities. Through such agreements, Connecticut and New Jersey demonstrated costs savings and improved health outcomes among adults in their state prison systems. One example the report cites is that these advances led to lower blood pressure among inmates who have hypertension.
  • Continuity of Medicaid coverage. By preventing gaps in health coverage when people are released from prison, states may help reduce the number of those who are incarcerated for new crimes or parole violations. Treatment for substance use and mental health is especially important in preventing recidivism; thanks to a program in Oklahoma, the number of inmates with severe mental illness who were enrolled in Medicaid on the day of their release increased by 28 percent. (For more information about data sharing among health and justice systems, visit, a project of the Vera Institute of Justice’s Substance Use and Mental Health program.)

As part of the State Health Care Spending Project, an initiative of Pew and the John D. and Catherine T. MacArthur Foundation, policy analysts from Vera’s Cost-Benefit Analysis Unit are surveying states about what they spend on correctional health care. The research will assess state spending on inmate medical care over time and the factors that drive costs up or down. The Pew project will publish the data as part of a study examining the full range of state health care expenditures.

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