This measure assesses the degree to which Vermont Medicaid initiates (starts) and engages (continues) treatment for members identified with a need for alcohol and other drug dependence (AOD) services. Two rates are reported for this measure:
The need for Vermont to work on our opioid use epidemic is well documented and has garnered media and public attention. Possibly less well known, is the fact that alcohol abuse, on its own, still represents the larger percentage of substance abuse for Vermonters. Please read further under “What Works” and “Action Plan” to learn more about what Vermont Medicaid is doing to help Vermonters prevent and treat substance abuse.
The treatment initiation rate remained steady during measurement year (MY) 2020, in spite of the pandemic. During that time the number of people seeking care for alcohol use decreased, but we saw increases in the number of people accessing care for opioids during the pandemic. The results of this measure are greatly impacted by the use of medication assisted therapy (MAT) and there were some changes in the federal regulations that gave more flexibility to providers and clients around MAT dosing and prescribing.
Last updated: September 2021
This link to the Vermont Department of Health website contains information about substance use treatment centers in Vermont, the Care Alliance for Opioid Addiction, medication assisted therapy (MAT), as well as other parent and community resources: http://www.healthvermont.gov/a...
This measure and this topic, Initiation of Alcohol and Other Drug Dependence Treatment, has been a high priority for Vermont Medicaid for years. Between 2013-2015 we worked on a grant funded Quality Improvement Project with the goal of increasing our substance use disorder treatment rates. We focused on opening up the Medicaid provider network to Licensed Alcohol and Drug Counselors (LADCs). We also offered a payment reform approach, by providing enhanced payment for quality outcomes. These strategies did not significantly increase the overall treatment rates for Medicaid beneficiaries.
Although this is clearly a multi-faceted and difficult issue to impact, we chose substance use treatment as a topic for a more formal Performance Improvement Project (PIP), results of which were submitted to CMS from 2017 - 2020. Department of Vermont Health Access (DVHA) Quality Unit staff partnered with staff in the Health Department's Alcohol and Drug Abuse Programs (ADAP), the Blueprint for Health and OneCare Vermont to design a project meant to drive more Vermonters newly diagnosed with a substance use disorder to treatment. The project's largest intervention focus was the promotion of telemedicine appointments. To that end, activities included: