pete looking at papers croppedPayers refers to organizations that pay for healthcare services. They include commercial insurance companies, Medicaid/Medicare, other public funding entities, Accountable Care Organizations, managed care organizations, Federally-Qualified Health Centers, and private foundations.

The Congregational Budget Office estimates that 26 million more Americans will have health insurance by 2017 as the result of the Affordable Care Act. Many of these individuals will have access to addiction treatment for the first time. Quality of care, rather than fee for service, is emphasized under the ACA.

This leaves payers with a litany of questions.

What is high quality addiction treatment? What are meaningful performance standards to hold providers accountable to?  How should medication-assisted treatment for opioid use disorders be administered? How should services be bundled?  Which ancillary services improve the effectiveness of addiction treatment and increase value?  Which models of integrating physical and behavioral healthcare are cost-effective and patient-centered?

In order to care for people and keep them healthy, you’re going to have to pay attention to substance use disorders. Incorporating addiction treatment and early identification is not only important—it’s critical to keeping people well.

– Peter Luongo, PhD

IRETA helps payers spend money wisely by increasing the quality of addiction care and improving patient outcomes.  

To help payers respond effectively to substance use and related problems, IRETA:

  • Creates treatment guidelines to guide service provision and measure quality in their provider network
  • Designs and implements clinical decision support tools to enable clinicians and administrators to systematically match patients with appropriate treatment
  • Designs and implements performance-based contracting
  • Provides expertise on the use of Screening, Brief Intervention and Referral to Treatment in various clinical settings

 

Related

IRETA Case Study: Clinical Guidance on Benzodiazepines and Medication-Assisted Treatment

IRETA Blog: Why Mainstream Healthcare Can’t Ignore Substance Use

IRETA Blog: Navigating the Gap, a compelling method for working in the space between addiction research and practice