The aim of this study is to expand on the literature concerning individual, provider, health plan, market, and environmental factors that influence initiation and engagement in SUD treatment services. Specifically, the research team examines how these factors affect health plan performance on the IET measures for both commercial and Medicaid health plans. Acknowledging that the reporting parameters of the IET measures themselves may influence how health plans develop quality improvement initiatives targeting health plan benefits or how providers and beneficiaries interact with treatment services related to substance use, we aim to use stakeholder interviews to provide insight on measurement performance.
Thus, the study has two overarching objectives:
Determine the models of care, quality improvement interventions, and best practices used by higher-performing health plans to improve initiation and subsequent engagement in SUD treatment.
Describe the provider, beneficiary, and market factors that affect their ability to successfully initiate and engage beneficiaries in substance use treatment services.
On the basis of existing literature, the research team hypothesized that health plans that performed well on the IET measures would be highly integrated behavioral and physical health service models; they would reimburse for a variety of substance use treatment-related services including case management, routine outreach, peer supports, outpatient, inpatient, partial hospitalization, and residential treatment; they would have high network adequacy and provide financial incentives for providers; and they might be more likely to serve smaller markets in a community-oriented model rather than be plans with large beneficiary enrollment covering diverse populations and geographic areas.