An OPEN MINDS Market Intelligence Report

How state Medicaid programs cover addiction treatment service—and what services they cover—varies from state to state. Addiction services can be categorized into three groups: detoxification (including inpatient detoxification, non-hospital-based detoxification); treatment (including outpatient treatment and residential treatment); and medications (including pharmacy and medication-assisted treatment). Among all state Medicaid programs, only two states offer no coverage for addiction treatment services and only six states offer the full continuum of addiction treatment services – inpatient detoxification, non-hospital-based detoxification, outpatient treatment, intensive outpatient, residential treatment, and medication-assisted treatment. (For more on state coverage of addiction services, see What Addiction Treatment Services Are Covered By State Medicaid Programs?: An OPEN MINDS Market Intelligence Report).

State-managed addiction treatment services varies widely as well, but most states use one of three main models to deliver addiction treatment services: Fee-for-service; Managed care, with no carve-out; or Managed care, with carve-out to a managed behavioral health organization.

A carve-out is a Medicaid managed care financing model where some portion of Medicaid benefits—dental services, pharmacy services, mental health services, addiction treatment services, etc.—are separately managed and/or financed. For addiction treatment benefits, the benefits are often broken down even further into specific service categories, including emergency services for addiction disorders, inpatient detoxification, detoxification in a non-hospital based setting, outpatient services, residential treatment, and methadone maintenance. These benefits can be managed in the same financing and delivery system or each service can be provided through a different financing and delivery system arrangement.

The OPEN MINDS Market Intelligence Team conducted an analysis of the 50 state and District of Columbia Medicaid programs. The analysis determines the delivery system for inpatient detoxification, detoxification in a non-hospital based setting, outpatient services, residential treatment, and methadone maintenance. The report answers a number of questions, including:

  1. What Is A Medicaid Carve-Out?
  2. Which States Carve Addiction Treatment Benefits Out Of Medicaid Managed Care Contracts?
  3. What Is The Future Of Addiction Treatment Carve-Outs?

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COVID-19 Risk Management Plan August 11, 2021

We are excited to return to sunny southern California for The 2021 OPEN MINDS Management Best Practices Institute at the picturesque Newport Beach Marriott Hotel & Spa, August 23-26, 2021. To help plan your in-person attendance, visit https://openminds.com/live-mbpi/ for a schedule of events happening throughout the week.

The resurgence of the COVID Delta variant has certainly created new challenges for the country and for our families. Fortunately, the available COVID vaccinations have been very successful in preventing symptomatic infections and illness. But I did want to let you know that our team at OPEN MINDS is committed to making our executive events as safe as possible and have an active risk management plan in place. I wanted to share with you the key elements of our plan:

We will continue to monitor any changes in the CDC recommendations for the continued safety of the public. If you have any concerns or questions, feel free to reach out to a member of our team at events@openminds.com or by phone at 877-350-6463. We look forward to seeing you at The 2021 OPEN MINDS Management Best Practices Institute.

Monica E. Oss
Chief Executive Officer
OPEN MINDS

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