How Do Medicaid Agencies Improve Substance Use Treatment Benefits? Lessons from Three States' 1115 Waiver Experiences.
Context: In 2015, the Centers for Medicare and Medicaid Services (CMS) urged state Medicaid programs to use 1115 waiver demonstrations to expand substance use treatment benefits. We analyzed four critical points in states' decision-making processes before expanding benefits. Methods: We conducted qu...
| Publicado en: | Journal of Health Politics, Policy & Law Vol. 47; no. 4; pp. 497 - 519 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | Artículo |
| Publicado: |
Duke University Press
Aug2022
|
| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=158245788&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 158245788 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 03616878 HPP jtl: Journal of Health Politics, Policy & Law issn: 03616878 maglogo: N pubinfo: dt: Aug2022 vid: 47 iid: 4 pid: 154 pub: Duke University Press artinfo: ui: 158245788 10.1215/03616878-9716740 ppf: 497 ppct: 22 formats: tig: atl: How Do Medicaid Agencies Improve Substance Use Treatment Benefits? Lessons from Three States' 1115 Waiver Experiences. aug: au: Crable, Erika Jones, David K. Walley, Alexander Y. Hicks, Jacqueline Milton Benintendi, Allyn Drainoni, Mari-Lynn affil: University of California San Diego Boston University su: United States Centers for Medicare & Medicaid Services (U.S.) Substance abuse treatment Medical quality control Interviewing Qualitative research Policy sciences Research methodology Comparative studies Descriptive statistics Research funding Thematic analysis sug: subj: Substance abuse treatment Medical quality control Interviewing Qualitative research Policy sciences United States Centers for Medicare & Medicaid Services (U.S.) Psychiatric and Substance Abuse Hospitals Outpatient Mental Health and Substance Abuse Centers Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs) Research methodology Comparative studies Descriptive statistics Research funding Thematic analysis keyword: 1115 waivers implementation science Medicaid substance use 1115 waivers implementation science Medicaid substance use ab: Context: In 2015, the Centers for Medicare and Medicaid Services (CMS) urged state Medicaid programs to use 1115 waiver demonstrations to expand substance use treatment benefits. We analyzed four critical points in states' decision-making processes before expanding benefits. Methods: We conducted qualitative cross-case comparison of three states that were early adopters of the 1115 waiver request. We conducted 44 interviews with key informants from CMS, Medicaid, and other state agencies, providers, and managed care organizations. Findings: Policy makers expanded substance use treatment in response to "fragmented" care systems and unsustainable funding streams. Medicaid staff had mixed preferences for implementing new benefits via 1115 waivers or state plan amendments. The 1115 waiver process enabled states to provide coverage for residential benefits, but state plan amendments made other services permanent parts of the benefit. Medicaid agencies relied on interorganizational networks to identify evidence-based practices. Medicaid staff secured legislative support for reform by focusing on program integrity concerns and downstream effects of substance use rather than Medicaid beneficiaries' needs. Conclusions: Decision-making processes were influenced by Medicaid agency characteristics and interorganizational partnerships, not federal executive branch influence. Lessons from early-adopter states provide a road map for other state Medicaid agencies considering similar reform. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
|---|