Election years can be a tumultuous time for behavioral health providers, with policy priorities set to change with the potential transition of power.
The substance use disorder (SUD) treatment industry can not only expect to be exempt from this turmoil but also enjoy more robust support from federal and state governments this year.
Election cycles can alter the makeup of the House and Senate and lame-duck periods can interrupt progress toward beneficial legislation. However, Peter Barbuto, vice president of business development at Recovery Centers of America, says he anticipates that the SUD industry will receive strong support from government bodies in 2024.
“This is certainly one issue that regardless of where you sit from a belief system politically, there’s a lot of alignment,” Barbuto said in a Behavioral Health Business webinar.
Recovery Centers of America (RCA) provides treatment for SUD and co-occurring mental health conditions. The company has 10 inpatient facilities, including one in Greenville, South Carolina which opened in recent months.
Both President Joe Biden and Former President and frontrunner in the Republican primaries, Donald Trump, have worked to curb the opioid epidemic.
President Biden created Opioid Awareness Week, called for a “historic” $46.1 billion for National Drug Control Program agencies, awarded more than $1.6 billion to communities addressing addiction and overdose crises and allocated $450 million to support prevention and treatment efforts.
With all signs pointing to another election between Biden and Trump, more national focus on SUD is all but guaranteed.
Opioid legislation specifically has significant opportunities for bipartisan cooperation, Robert Blendon, professor emeritus at the Harvard T.H. Chan School of Public Health, said in an online forum hosted by the Bipartisan Policy Center.
“What makes the bipartisan possibilities unbelievable is [that the opioid crisis disproportionately impacts] rural America and central cities,” Blendon said. “You have Democrats in cities and senators from rural states who absolutely agree we have to do something.”
A look back at 2023
SUD treatment was top of mind for lawmakers in 2023.
The X-waiver, which limited the prescribing of buprenorphine, was rescinded in January.
In March, a bipartisan group of legislators announced the Modernizing Opioid Treatment Access Act, which called for easing regulations surrounding methadone dispensing.
In June, the Substance Abuse and Mental Health Services Administration (SAMHSA), the Office of Recovery and the U.S. Department of Health and Human Services (HHS) released new national model standards for peer support certification. The standards were designed to support increased adoption of a peer mental health workforce, which “play[s] a crucial role in overdose prevention, crisis intervention, and in the promotion of recovery, resiliency and well-being across the nation.”
SUD treatment providers can expect support from state agencies as well as federal.
“There is a significant focus [on SUD] from all the states that we operate in,” Joe Bond, founder and CEO of Cedar Recovery, said on BHB’s webinar. “There’s a lot of work across the aisle when it comes to behavioral health and substance use. I don’t see that subsiding in any way, shape or form, [regardless of] whoever sits in the Oval Office this time next year.”
Cedar Recovery has nine physical locations in Tennessee as of September 2023. Patients receive both medication-assisted treatment (MAT) and behavioral therapy as part of individualized recovery plans.
Looking to 2024
Legislation can help normalize SUD as a disease, according to Bond.
The stigma surrounding SUD treatment can have deadly consequences. It can prevent people from seeking or staying on medications for opioid use disorder (MOULDs), which is considered the gold standard treatment plan.
“I think that we’re now beginning to realize that if we don’t treat this as a moral failure… the stronger and the better [can] we do as a country and as states [to] lead people to treatment,” Bond said. “I believe that we’re going to get people able to be running towards [treatment] rather than away from it because they’re not embarrassed or ashamed.”
Beyond potential new legislature in 2024, government-based payers may also be the best source for value-based care arrangements.
Value-based care remains relatively rare in the SUD treatment field but can lead to higher reimbursement rates and more value for patients and payers.
“The commercial payers are a little slower to move to [alternative payment models] and theories behind that,” Bond said. “I’ll just say that the government payers have been more active in that.”
The “lion’s share” of RCA’s reimbursement comes from commercial payers, Barbuto said, but the company does have “unique” arrangements with government payers. RCA seeks alternative payment models with all payers.
“It’s important to know that these conversations exist and need to exist with all of your partners on the payer side,” Barbuto said.