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Addiction Treatment in Healthcare Reform

Addiction Treatment in Healthcare Reform. Tom McLellan, Jan 21, 2010. Substance Abuse. Specialty Treatment ~ 2,300,000. Abuse/Dependent – 25,000,000. “Harmful Users” – ??,000,000. Little or No Use. Specialty Care Today. ~ 12,000 specialty programs in US 77% government funded

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Addiction Treatment in Healthcare Reform

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  1. Addiction Treatment inHealthcare Reform Tom McLellan, Jan 21, 2010

  2. Substance Abuse Specialty Treatment ~ 2,300,000 Abuse/Dependent – 25,000,000 “Harmful Users” – ??,000,000 Little or No Use

  3. Specialty Care Today ~ 12,000 specialty programs in US 77%governmentfunded Primarily Block Grant - $2B Private insurance <12% No parity – Many inequities

  4. Specialty Care Soon ~ 12,000 specialty programs in US + 8,000 FQHCs(27 million patients) Block Grant + Medicaid ($70 B) ~ 60% of those not covered 100% Federal – No State Match Parity Requires = Coverage

  5. National Prevention System Engage Primary Care Treat Addiction as a Disease Emphasis on Offenders Performance Monitoring Five Priorities

  6. Themes • Evidence Based Interventions • Delivered Within Communities • Investment in Infrastructure

  7. Intervention

  8. A Continuing Care Model Primary Care Specialty Care Primary Continuing Care

  9. Continuing Care In Addiction Screen Intervene Monitor Refer Primary Care Stabilize Motivate/Medicate Train Self-Mgmnt Refer Specialty Care Recovery Support Services Re-Intervene Monitor/Support

  10. Primary Care 4. Expand SBIRT Code and Financing 5. Train/Motivate Generalist Physicians 6. Coordinate & Expand Prescription Drug Monitoring Programs

  11. Treatment

  12. Treatment • Integrate Addiction Treatment into Federal Healthcare Systems 8.Performance Contracting in State Treatment Systems 9. Consumer Choice Through Vouchers for Recovery Services

  13. Recovery “A voluntarily maintained lifestyle characterized by sobriety, personal health and citizenship” J. Substance Abuse Trt, 2008

  14. Community Corrections

  15. Opportunities to Intervene Pre-Arrest Pre-Trial 700,000/yr Released Prosecution Sentencing ~5 Million Offenders In Community In Jail/Prison Re-Entry

  16. Corrections 10. Drug Treatment Alternatives to Prison Continued Emphasis on Drug Courts 11. Offender Re-Entry Programs 12. Screening and Brief Treatments of Juvenile Offenders with MH and SA Problems

  17. National Prevention System Engage Primary Care Close the Addiction Tx Gap Special Care for Offenders Improved Data Systems Five Priorities

  18. Thank You

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