There is great variability in the administrative structures within each state, including use of managed care arrangements to support these activities. The opioid crisis highlighted the importance of not only the identification and treatment of opioid and other SUD, but the need for continued reduction of the stigma that can impede access to treatment, as well as an understanding of the evidenced-based interventions that can and do support individual recovery. These are the core challenges SUD policy makers and funders face. 

As states have pursued 1115 SUD waivers to expand services reimbursed through Medicaid programs, state and county SUD authorities have had to support their provider networks to enroll in and navigate Medicaid program requirements. Administrators have recently found ways to support the continued evolution of SUD treatment across the continuum of care with initiatives such as implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT) programs; reimbursement for Medication-Assisted Treatment (MAT) and requirements for access to MAT within community and residential treatment settings; and innovative care management programs that include health homes for individuals with SUD, and rapid response within emergency departments and following inpatient discharge that leverages peer and mobile community providers.

Managing competing demands for funding and taking a lead role in partnering with SUD system stakeholders to continuously evolve with improvement in the SUD field, all while maintaining access to the current system of care can be challenging. The HMA Institute on Addiction (HMA IOA) team recognizes this because we have faced these challenges while serving in similar roles. Our team consists of former state and county administrators who share a passion for this important work. Our team is also comprised of individuals who have served in executive leadership positions with managed care organizations responsible for administering behavioral health benefits.