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Medicaid Approved to Pay More for Addiction Treatment

Medicaid Approved to Pay More for Addiction Treatment

Reimbursements for Residential Care

This past Wednesday, an increase in Medicaid reimbursement rates was approved by the Executive Council in New Hampshire for providers of residential addiction treatment. This creates a new sense of hope for those in need of treatment opportunities in the Granite State. Treatment providers in the area had previously cautioned that many may be soon forced to reduce both the number of beds and services offered in their programs. In the midst of an ongoing opioid crisis in the United States, losing resources for addiction care could have made it that much harder for the nation to recover. Especially in a state with the second highest overdose death rate in the country.

In 2016, 437 deaths were opioid-related overdoses according to the National Institute on Drug Abuse. While that may not seem like much, that rate per capita is 35.8 per every 100,000 people. That is almost three times higher than the national average. Therefore, reducing options for addiction treatment could be extremely devastating in these communities.

A New Beginning in the New Year

Back in 2014, the state expanded its Medicaid program to put people on private health plans that paid more for services. However, with the extension of the program for another five years, the state is switching to a managed care model. This translates to lower reimbursement rates set by the state. Conversely, the state’s new 10-year plan for mental health care highlights the necessity of increasing Medicaid reimbursements. Currently, New Hampshire has one of the lowest reimbursement rates for Medicaid in the nation. This new increase would almost double the payout to providers.

Jeffrey Meyers, the Health and Human Services Commissioner, reported on Wednesday to the Executive Council that his department was able to increase the rates while staying within its budget. Under this new plan, compensation for high-intensity, residential addiction services could increase from $162 per day to $347 per day. These Medicaid payment changes would go into effect starting January 1, 2019.

Meyers department took into account the rates they found in other New England states. Additionally, they compared them to reimbursement rates found in:

  • Ohio
  • West Virginia
  • Kentucky

This makes perfect sense, considering each of these states is among those suffering the most through the opioid epidemic. When comparing, one will notice that New Hampshire’s reimbursement rates for outpatient services were generally in line with other state. However, the rates for residential level of care are significantly lower. The new plan, Granite Advantage Health Care, aims to align New Hampshire with neighboring states in supporting those who need help.

Maintaining Quality of Care

When you consider the death rate relating to drugs in New Hampshire, and the drastic changes in reimbursement, one essential aspect of this plan has to be maintaining a quality of care for patients. When insurance companies fight to pay less for treatment services, many providers struggle to maintain that quality of care for their clients. Democratic Councilor Chris Pappas on the Executive Council made it a point to seek assurances that the increased reimbursement rate would ensure that services would not be cut.

For now, the new rates will only be effective for six months. However, Meyers remains confident that ensuring adequate services will be a key factor in the next process of determining the budget. Chris Sununu, the Republican Governor of New Hampshire, agrees that quality of care will be a priority. Sununu states,

“Because we are now paying rates that are commensurate with the surrounding area, there’s no reason to feel that any of the services would be denied or cut because we’re on par with everyone else,”

Professionals from local treatment providers believe this could be crucial progress in a positive direction. However, there are some concerns with the limits to its scope. For example, the increase:

  • Excludes costs for detox services
  • Does not apply to non-opioid treatment

While opioids may be the driving force behind overdose deaths, limiting treatment reimbursements to only cover these patients still leaves a lot of people in need of support. Furthermore, safe medical detox is a critical stage of an effective treatment program. Without offering more resources to help people address the immediate issue of getting off drugs in a safe and supportive environment, it could still hinder the progress made from reaching it’s full potential.

Making treatment available to those who need it is the only way to ever recovery as a country from the current drug crisis. That is why our mission is to provide effective and innovative care to every client. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now 1-800-755-9588.


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