Section 1115 Demonstration Waiver for Substance Use Disorder (SUD) Treatment

Goals and Milestones

Goals:

  1. Increased rates of identification, initiation and engagement in treatment for OUD and other SUDs;

  2. Increased adherence to and retention in treatment for OUD and other SUDs;

  3. Reductions in overdose deaths, particularly those due to opioids;

  4. Reduced utilization of emergency departments and inpatient hospital settings for OUD and other SUD treatment where the utilization is preventable or medically inappropriate through improved access to other continuum of care services;

  5. Fewer readmissions to the same or higher level of care where readmissions are preventable or medically inappropriate for OUD and other SUDs; and

  6. Improved access to care for physical health conditions among beneficiaries with OUD and other SUDs.

Milestones:
  1. Access to critical levels of care for OUD and other SUDs;

  2. Widespread use of evidence-based, SUD-specific patient placement criteria;

  3. Use of nationally recognized, evidence-based, SUD program standards to set residential treatment provider qualifications;

  4. Sufficient provider capacity at each level of care, including medication assisted treatment (MAT);

  5. Implementation of comprehensive treatment and prevention strategies to address opioid misuse and OUD; and

  6. Improved care coordination and transitions between levels of care.