Catalyst for Payment Reform

Time to tackle substance use disorders head on

Time to tackle substance use disorders head on

We know behavioral health care is a major cost driver for employers and other health care purchasers, often displaying double digit growth year over year. But did you know that substance use disorders make up about half of that growth? NIH’s National Institute on Drug Abuse has found that the annual cost of substance use disorders is more than $740 billion.

The rising costs are not what make this a national crisis though. Substance use disorders negatively impact people’s health and wellness, exacerbate other health conditions, and often lead to overdose or death. How can we collectively help those with substance use disorder get the care they need?

Part of the problem is that our health care ecosystem is not equipped yet to effectively prevent and treat these substance use disorders. Employers find there is a shortage of providers prepared to manage employees in need. According to Mental Health America, over 4,000 areas across the United States, with more than 110 million people, are in shortage of mental health professionals. In addition, about 55.8% of adults with mental illness did not receive treatment. Moreover, it’s unclear how effective many treatments are at actually mitigating the substance abuse dependency. The interventions that have been proven to make a positive impact are underutilized. For example, providers do not readily prescribe medication-assisted treatments like methadone or buprenorphine, despite the fact that evidence shows they are clinically effective.

Employers and other purchasers need a concrete way to tackle substance use disorders head on. Luckily, CPR is here to help. With the support of Dr. Corey Waller, a seasoned specialist in pain and addiction medicine, CPR is launching an employer-purchaser collaborative, Encouraging Evidence-based Treatments for Substance Use Disorders. Over the course of a year, we will examine benefit and network design and payment reform strategies that can encourage patients with substance use disorders to seek appropriate care and incentivize providers to prescribe evidence-based treatments. This is one way we can make a difference on this issue.

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