Establishing pilot project to evaluate impact of certain post-substance use disorder residential treatments
Impact
The legislation is set to change how treatment facilities are reimbursed, directing at least 15 percent of their contracts to be contingent on the measured performance of their services. This approach is anticipated to incentivize facilities to adopt evidence-based practices and enhance their post-treatment support programs. The intent is to connect discharged patients with necessary supports such as job placement, housing assistance, and ongoing medical care, ultimately leading to better recovery rates and reduced recidivism into substance use behaviors.
Summary
SB419 is a significant piece of legislation that amends the Code of West Virginia by establishing a pilot program focused on performance-based contracting for substance use disorder residential treatment facilities. The bill mandates that the Department of Health and Human Resources create contracts with managed care organizations (MCOs) that link payments to the outcomes achieved in treating patients with substance use disorders. This initiative aims to evaluate the effectiveness of post-discharge planning and the provision of comprehensive wraparound services to improve long-term recovery outcomes.
Sentiment
Overall, the sentiment surrounding SB419 appears to be positive among legislators and advocates for substance use disorder treatment, as it seeks to bring accountability and evidenced results to healthcare funding. However, it has also sparked discussions about the potential implications of performance metrics on patient care. While proponents laud the initiative for its focus on outcomes and improving services, there are concerns that such metrics might prioritize financial considerations over individual patient needs.
Contention
Notable points of contention include the concern over how performance metrics will be defined and the varying impact these might have across different treatment facilities. Critics argue that financial limitations imposed by performance-based contracts might hinder some providers from delivering comprehensive care. Additionally, the oversight and evaluation process set forth by the bill raises questions about the adequacy of resources allocated for monitoring the pilot program, which is intended to last for three years before a potential reevaluation.
Requires coverage for residential/inpatient mental health services for detox/stabilization/substance abuse disorders without preauthorization or be subject to concurrent review during the first 28 days.
Requires coverage for residential/inpatient mental health services for detox/stabilization/substance abuse disorders without preauthorization or be subject to concurrent review during the first 28 days.