The Centers for Medicare & Medicaid Services (CMS) announced the selected applicants for the Value in Opioid Use Disorder Treatment Demonstration, also known as the Value in Treatment Demonstration.
Starting in April 2021, this four-year demonstration tests whether a new care management fee and performance-based incentive for opioid use disorder (OUD) treatment services can cut hospitalizations and improve health outcomes for individuals with OUD. This demonstration will increase access to OUD treatment services, to improve physical and mental outcomes for eligible Medicare Fee-For-Service beneficiaries, including those dually eligible for Medicare and Medicaid, while reducing Medicare program expenditures to the extent possible.
The selected applicants that sign the Value in Treatment participation agreement with CMS will be part of the demonstration, which creates two new Medicare payments for participating providers and suppliers. Those payments include a per beneficiary, per month care management fee and a performance-based incentive payment. Participants can use these additional payments for patient-centered OUD treatment services expected to result in improved outcomes and cost savings among people with health and social needs that go beyond the clinical services that Medicare currently covers.
The selected applicants include physicians, hospitals, health centers, treatment programs, and more. They are enrolled Medicare providers, practitioners and suppliers that have an OUD care team to give or arrange for OUD treatment services in the outpatient setting.
The demonstration is authorized under section 1866F of the Social Security Act, which was added by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act), which makes available $10 million from the Federal Supplementary Medical Insurance Trust Fund for each of fiscal years 2021 through 2024 to pay participants for Value in Treatment services.
