How Virginia Reformed Medicaid To Accelerate Access To Addiction Treatment
For a new article in Health Affairs, former Virginia Department of Medical Assistance Services (DMAS) Chief Medical Officer Chethan Bachireddy and DMAS Senior Program Advisor Ashley Harrell collaborated with Department of Health Policy professor Andrew Barnes on an extensive article detailing the reforms made to Virginia Medicaid’s addiction treatment processes between 2017 and 2022. In the article, they explain how expanding Medicaid to cover a larger percentage of Virginia’s low-income residents, increasing provider participation in Medicaid programs, and creating targeted programs such as ARTS (Addiction and Recovery Treatment Services) helped create improvements in Virginia’s treatment of substance use disorders.
Addiction treatment is essential to addressing the worsening overdose crisis in the United States. Drug overdose deaths in the United States increased more than 50 percent since the COVID-19 pandemic, from 70,630 deaths in 2019 to 107,941 deaths in 2022.
Opioids are involved in the vast majority of fatal overdoses. And so, medications for opioid use disorder (MOUD) are an essential component of effective treatment. However, only 22 percent of individuals who could benefit from MOUD actually receive them.
Notably, Medicaid — which covers almost 40 percent of all those with opioid use disorder (OUD) — has the potential to improve access to effective addiction treatment through thoughtful policies that expand coverage, increase provider willingness to offer services, and facilitate high-quality patient-provider interactions.
The recent experience of Virginia Medicaid is illustrative. From 2017 to 2022, the agency implemented targeted reforms in each of these areas. These efforts contributed to a 486 percent increase in Medicaid-participating addiction treatment providers and a 592 percent increase in Medicaid members receiving MOUD.
As the former chief medical officer and current senior program adviser of Medicaid in Virginia two of us (Bachireddy and Harrell, respectively) played a key role in these reforms. Below, we describe these reforms in greater detail, results achieved, and future directions.
Expanding Coverage
Insurance coverage is fundamental. Without it, many individuals with substance use disorders will not be able to access and pay for care. Alarmed by the rise in overdose deaths across the state, in April 2017, Virginia responded by introducing a new Medicaid benefit called Addiction and Recovery Treatment Services or ARTS…
Read the full article here.
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