SAMHSA Releases Report Exploring Best Practices in Value-Based Payment in Substance Use Disorder Services

The Substance Abuse & Mental Health Services Administration (SAMHSA) has released a new report providing an overview of the current adoption of Value Based Payments (VBP) for substance use disorder (SUD) services. The report, “Exploring Value-Based Payments for Substance Use Disorder Services in the United States” provides a summary of best practices and strategies to overcome barriers to implementing SUD-focused programs.

VBP models pay health care providers based on the value rather than the volume of services. VBP models have the potential to improve delivery of the integrated and coordinated care necessary for the complex and continuing needs of individuals who are living with SUD.

Different states are exploring various ways to integrate VBP into SUD care. Some have passed laws to require VBP, others are using Section 1115 Demonstration Waivers to set VBP goals across their Medicaid managed care contracts. Others are funding VBP models using state or federal grant programs. This report provides a state-by-state review of the current status of VBP approaches being conducted across SUD services and explores chalnges and potential solutions to implementing value-based payments for substance use disorder services.

VBP Models have been the topic of much recent discussion. A recent article in published  Behavioral Health Business discussed some of the challenges payers and providers have experienced when trying to implement VBP care in addiction treatment, leading to low adoption of VBP contracting. One of the leading hurdles for both payers and providers is the lack of industry-level consensus on what measures best reflect the value of care. Others include gaps in technology to track outcomes, difficulties adopting a widely applicable reimbursement strategy, and frequent changes in health plan benefits – with a many as 60% of plan members leaving any given health plan within the average span of two years.