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Addiction Treatment Services

Addiction is a chronic disease, which causes individuals to seek “reward” from substance-use or other activities whether or not they may cause harm. Addiction treatment has been in the spotlight as payers, policymakers, and health systems struggle to address the opioid crisis and increasing substance-related mortality rates. As a result, the addiction treatment market is shifting—there is expanded coverage for residential treatment, a push towards greater integration and care coordination, and new competitors entering the market—creating new challenges and opportunities for organizations working in addiction treatment.


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Six states that implemented Section 1115 waivers covering Medicaid payments to Institutions for Mental Disease (IMDs) for substance use disorder (SUD) treatment reported that higher utilization of inpatient and residential SUD treatment, with some evidence of expanded treatment capacity. Using IMDs as a treatment setting expanded access to services and medications for opioid use disorder (OUD). The six states are California, Indiana, Massachusetts, New Hampshire, Utah, and Washington. Historically, Medicaid has not reimbursed for services… Read