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Economic Grand Rounds
Published Online: 11 December 2019

Private Coverage of Methadone in Outpatient Treatment Programs

Abstract

Among the three medications approved for the treatment of opioid use disorder, methadone has been in use for the longest period and has the most extensive evidence base of effectiveness. Yet it remains underutilized as new insurance policies favor access to buprenorphine and neglect to dismantle barriers to obtaining methadone. In the absence of wholesale regulatory change, private insurance carriers should take the lead in expanding access to this medication. We offer several solutions for private payers, including expanding coverage, removing prior authorization, addressing out-of-pocket costs, increasing provider reimbursement, and incentivizing system integration.

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Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 303 - 306
PubMed: 31822242

History

Received: 25 July 2019
Revision received: 16 September 2019
Accepted: 17 October 2019
Published online: 11 December 2019
Published in print: March 01, 2020

Keywords

  1. Drug abuse
  2. Methadone
  3. Insurance

Authors

Details

Daniel Polsky, Ph.D. [email protected]
Department of Health Policy and Management, Bloomberg School of Public Health, and Carey Business School, Johns Hopkins University, Baltimore (Polsky); Shatterproof, New York (Arsenault); Optum Behavioral Health, San Francisco (Azocar). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
Samantha Arsenault, M.A.
Department of Health Policy and Management, Bloomberg School of Public Health, and Carey Business School, Johns Hopkins University, Baltimore (Polsky); Shatterproof, New York (Arsenault); Optum Behavioral Health, San Francisco (Azocar). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
Francisca Azocar, Ph.D.
Department of Health Policy and Management, Bloomberg School of Public Health, and Carey Business School, Johns Hopkins University, Baltimore (Polsky); Shatterproof, New York (Arsenault); Optum Behavioral Health, San Francisco (Azocar). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.

Notes

Send correspondence to Dr. Polsky ([email protected]).

Funding Information

This study was supported by Arnold Ventures (formerly the Laura and John Arnold Foundation).Dr. Azocar is an employee of Optum-UnitedHealth Group. The other authors report no financial relationships with commercial interests.

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