RESEARCH TRIANGLE PARK, N.C.— RTI International, a nonprofit research institute, will evaluate an innovative Medicare opioid use disorder (OUD) treatment model that is being piloted by the Centers for Medicare & Medicaid Services (CMS). The treatment model aims to increase access to OUD services for Medicare beneficiaries, improve physical and mental health outcomes for these beneficiaries, and reduce Medicare expenditures. Providers participating in the demonstration will use OUD care teams and will receive care management payments and performance-based incentives.
“In the 12 months ending January 2021, there were over 94,000 drug overdose deaths in the U.S. – the largest number of yearly drug overdoses on record,” said Tami Mark, Ph.D., Senior Fellow, Behavioral Health Financing and Quality Measurement at RTI and senior advisor for the new evaluation. “Opioid-related harms have also increased among Medicare beneficiaries. Medicare began offering opioid treatment program coverage (a highly effective intervention for OUD) in January 2020. The demonstration may offer a model for filling in gaps in Medicare OUD services and encouraging high quality, coordinated Medicare OUD treatment delivery.“
The RTI team will evaluate CMS’s approach using quantitative analyses of claims data for Medicare beneficiaries participating in the treatment demonstration compared to a group of beneficiaries not participating. They will also survey Medicare beneficiaries and review other information collected from participating providers.
The findings will be presented to Congress in an intermediate report and final report.
“Between 2006 and 2016, we watched the number of Medicare beneficiaries misusing opioids double and between 2010 and 2015, the number of opioid-related emergency room visits increase by 74 percent,” said William Parish. Ph.D., a health economist at RTI and project director for the evaluation. ”RTI is committed to improving treatment options for individuals with OUD and pleased to be able to support CMS in evaluating this innovative approach to OUD delivery and financing.”