January 10, 2024

Value-Based Payment for Substance Use Disorder Services in the United States

Implementing Value-based payment (VBP) models in substance use disorder (SUD) treatment marks a significant step towards a more patient-centered, outcomes-driven healthcare system. By aligning financial incentives with positive patient outcomes, VBP has the potential to enhance the quality, accessibility, and efficiency of SUD treatment services. Addressing challenges such as data standardization and provider resistance is crucial for the successful integration of VBP, ultimately contributing to improved individual well-being and reduced societal burdens associated with SUD.

In November of 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA) released the report “Exploring Value-Based Payment for Substance Use Disorder Services in the United States.” At the core, this report explores the use of VBP models and the potential to improve the delivery of integrated and coordinated substance use disorder (SUD) treatment services. The report includes a detailed synopsis of the progress individual states are making with respect to shifting away from fee-for-service reimbursement methodologies across both government-sponsored and commercial insurance.

On November 13, 2023, Third Horizon Strategies Senior Director Eric Bailly along with Allison Marlatt, Health Insurance Specialist, State Innovation Group at Centers for Medicare & Medicaid Services (CMS), and Tyler Sadwith, Deputy Director Behavioral Health at the California Department of Health Care Services, participated in a joint Center for Financing Reform and Innovation (CFRI) and SAMHSA webinar panel featuring the report’s findings. ¬†Over 1800 people registered for this event, with over 300 attending the live webinar and approximately 250 viewing the webinar online.

To learn more about the Alliance for Addiction Payment Reform, please visit www.incentivizerecovery.org. There is no fee for joining the Alliance Learning Collaborative! To join, click “Join the Collaborative” on the landing page. Please reach out to eric@thirdhorizonstrategies.com with any questions. Also, the next quarterly Alliance for Addiction Payment Reform meeting will be held on Wednesday, 3/13/2024, from 3:00 to 4:30 PM ET. (TBD Guests). Click here to register for any of the four quarterly meetings scheduled for 2024: https://incentivizerecovery.org/quarterly-meetings/