CMS Issues Guidance on Substance Use Disorder Care Delivery Transformation
Wednesday, the Centers for Medicare and Medicaid Services (CMS) issued an Informational Bulletin outlining a framework for states to transform their substance use disorder care delivery systems and offering opportunities for states to receive intensive technical assistance through an upcoming learning collaborative.
The efforts outlined in the bulletin are part of CMS’ recently launched Innovation Accelerator Program (IAP), which assists states’ efforts to Medicaid system reform efforts through the development of new delivery models, data analytics, quality measurement, and rapid-cycle learning and evaluation. CMS has identified substance use disorders as a principal area of focus for IAP efforts and encourages states to take advantage of IAP support to improve and expand substance use care delivery in Medicaid.
The new informational bulletin outlines areas of focus for states to consider as they embark on efforts to improve substance use disorder care delivery and coverage. These include:
- Establishing a comprehensive benefit design;
- Ensuring care coordination and integration with physical and mental health services;
- Focusing on care transitions among levels of care;
- Sharing information among providers while complying with federal and state confidentiality requirements;
- Developing a strategy to identify and treat substance use disorders among youth;
- Using data analytics to collect, use and report relevant quality measures; and
- Assisting substance use disorder providers with enhancing their business operations.
The Informational Bulletin also identifies existing programs and pathways by which states can pursue delivery reform, such as implementing health homes for enrollees with chronic conditions or utilizing a variety of Medicaid waivers. Of note, CMS expressly states that section 1115 waivers may be used to allow states to cover services normally prohibited by federal statute, such as short-term residential substance use treatment. The agency is developing additional guidance on this topic, to be released in an upcoming publication.
To help states achieve their substance use disorder delivery reform goals, CMS announced it will launch a high-intensity learning collaborative open to any state that expresses interest and commits to producing the necessary reforms. The learning collaborative will consist of monthly peer-based learning sessions, bimonthly “deep dive” webinars, and intensive technical assistance and support from CMS. Interested states are asked to submit a brief Expression of Interest form (found at the end of the Informational Bulletin) and schedule a time to discuss their interest with CMS by phone.