State sees increase in addiction treatment access as lawmakers consider expanding care

State sees increase in addiction treatment access as lawmakers consider expanding care
Drug paraphernalia lies on the floor inside an abandoned home in Appalachia, Va., where neighbors say the previous residents cooked meth before they were arrested. (Source: Ned Oliver/ Virginia Mercury)

A state agency is reporting substantial gains in addiction treatment under Virginia’s Medicaid expansion — a report that comes as lawmakers consider several budget proposals to expand the continuum of care for substance use disorders.

The state unrolled new addiction treatment services in 2017 when 1,536 state residents died of fatal overdoses. That year, Virginia Medicaid launched a new benefit called Addiction and Recovery Treatment Services (ARTS), which expanded Medicaid coverage for inpatient detoxification, residential treatment and other addiction-related services.

At the time, Virginia was one of the “leaders in the nation” when it came to covering addiction treatment through Medicaid, said Karen Kimsey, director of the state’s program. A new two-year evaluation, published by researchers with the Department of Health Behavior and Policy at Virginia Commonwealth University, found that treatment rates more than doubled among Medicaid patients in the first two years of the program.

“ARTS has had a profound impact on access to addiction treatment services for the Medicaid population,” said Peter Cunningham, the lead author of the report. “It’s a continuation of the trend we saw after the first year that showed this program has really been effective.”

The reach has only grown since lawmakers approved Medicaid expansion. In the first three months after coverage took effect — on Jan. 1, 2019 — 12,000 new patients with substance use disorders enrolled in health care coverage. The ARTS program, combined with health care expansion, has offered more resources to more patients as the state aggressively pursued more treatment options for Medicaid patients.

Because of low reimbursement payments to doctors, many providers choose not to accept Medicaid, limiting options for low-income patients.

But Kimsey said the state worked with providers and consulted the commercial market to raise reimbursement rates for addiction services. During the second year of the ARTS program, more than 4,000 practitioners billed Virginia Medicaid for addiction treatment services. The state’s Department of Health also helped providers become certified to prescribe buprenorphine — a medication used in addiction treatment.

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