Substance Use Disorders in the U.S. Armed Forces (2013) / Chapter Skim
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4 Changing Standards of Care for Substance Use Disorders
4 Changing Standards of Care for Substance Use Disorders
Pages 85-96
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From page 85... ...
In addition to health care reform, emerging expectations from the Office of National Drug Control Policy and the National Quality Forum will affect alcohol and other drug prevention and treatment services. HEALTH CARE REFORM AND PARITY REQUIREMENTS The Patient Protection and Affordable Care Act of 2010 (hereafter referred to as the Affordable Care Act)
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From page 86... ...
Accountable Care Organizations and Integrated Care The Affordable Care Act generally promotes the integration of mental health and SUD treatment with primary care services and makes integrated care a priority for community-based accountable care organizations (ACOs) .1 ACOs reflect emerging standards and expectations for integrated, patient-centered care provided within a medical home that is financially responsible for coordinating a patient's health care, including care for mental health disorders and SUDs.
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From page 87... ...
is a recent example of the value of integrated care. In this study, 10 HIV clinics provided integrated medication-assisted opioid treatment.
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From page 88... ...
Patient Placement and Levels of Care Many health care systems use the American Society of Addiction Medicine's (ASAM's) Patient Placement Criteria to determine appropriate levels and intensity of addiction treatment services.
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From page 89... ...
In addition to state mandates to use the ASAM criteria, DoD and national health care organizations and health plans require that an ASAM level-of-care assessment guide treatment plans. The ASAM placement criteria provide a common language with which care providers and care managers can communicate about the multidimensional assessment and placement decision for those with SUDs.
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From page 90... ...
ONDCP's National Drug Control Strategy reflects a substantive change in federal policy: for the first time, addiction treatment resources are allocated to primary care settings rather than specialty clinics. The 2011 strategy also instructs federal agencies that address health care needs to meet the National Quality Forum's voluntary consensus standards for treatment of alcohol and other drug use disorders (see the next section)
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From page 91... ...
For the first time, a national trade organization recommended that its membership implement specific evidence-based therapies for treating tobacco, alcohol, and other drug use disorders. The standards are applicable to all members of the National Quality Forum (national consumer advocacy groups, health professional trade associations, health systems, health plans, groups that purchase health plans, pharmaceutical companies, and research institutes)
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From page 92... ...
Behavioral health care organizations learn to use Plan-DoStudy-Act change cycles to reduce days to admission, improve retention
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From page 93... ...
NIATx, like IHI, demonstrates that system change can lead to improved clinical and administrative practices. Agencies adopting process improvements have increased the use of medications for specific diagnoses, screening and brief intervention in primary care settings, and adoption of evidence-based psychosocial clinical interventions; enhanced posttreatment aftercare; and facilitated case management, wrap-around, and supportive services.
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From page 94... ...
Health care reform and federal parity legislation enhance access to health insurance and mandate that commercial health plans provide similar coverage for general health care, mental health care, and care for alcohol and other drug use disorders. Advocates and policy makers have called for increased integration of addiction treatment and primary care, and DoD is uniquely positioned to take advantage of this opportunity.
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From page 95... ...
2007a. Direct care workers in the national drug abuse treatment clinical trials network: Characteristics, opinions, and beliefs.
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From page 96... ...
2011. Behavioral health insurance parity: Does Oregon's experience presage the national experience with the Mental Health Parity and Addiction Equity Act?
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