Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
Psychiatr Serv. 2019 May 1;70(5):428-431. doi: 10.1176/appi.ps.201800543. Epub 2019 Feb 13.
Medicaid stands to play a significant role in addressing the needs of individuals with a substance use disorder; however, many state Medicaid programs do not cover a full continuum of care. A growing number of states are taking advantage of Section 1115 demonstration waivers to augment their covered benefits, including experimenting with financing residential treatment services that previously were not eligible for reimbursement. Concerns over potential overuse of these services or increased spending due to this service expansion may be tempered by complementary delivery system transformation focused on reining in costs and improving care quality.
医疗补助在满足药物滥用患者的需求方面发挥着重要作用;然而,许多州的医疗补助计划并未涵盖全面的护理服务。越来越多的州正在利用第 1115 条示范豁免来增加其覆盖的福利,包括尝试为以前不符合报销条件的住院治疗服务提供资金。对这些服务可能被过度使用或由于服务扩展而导致支出增加的担忧,可以通过关注控制成本和提高护理质量的补充交付系统转型来缓解。