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The Latest Research, Commentary, And News From Health Affairs

Monday, February 22, 2021

Dear John,

Welcome to

**Health Affairs Today**. You may notice the newsletter looks a little
different.

We've made some content and design improvements to make it even easier
for readers to find the most important health policy news and insights
they depend on.

We'll still highlight the latest journal content
,
our blog
,
and our collection of podcasts
.
Now we'll also include more context and background.

Today, we are focusing on Medicaid waivers for residential substance use
disorder (SUD) treatment
.
Organizations are investing in prevention
,
but many individuals rely on Medicaid help to support their SUD
treatment costs.

Let's get into it.

Medicaid Waivers For SUD Treatment

As part of the original Medicaid legislation, the Institutions for
Mental Diseases exclusion prohibited Medicaid from covering behavioral
health services for many enrollees residing in residential treatment
facilities.

Thanks in part to the ACA
,
Medicaid has since grown into an important source of payment for
behavioral health services, including substance use disorder (SUD)
treatment. A major breakthrough came in 2015 when the Centers for
Medicare and Medicaid Services

provided a streamlined approval process for granting state Medicaid
waivers to help SUD care delivery.

After adopting these waivers, states saw significant increases in
acceptance of Medicaid coverage at residential treatment facilities
,
according to a study by Johanna Catherine Maclean and coauthors in the
February issue of

**Health Affairs**. Interestingly, intensive outpatient treatment
facilities' acceptance of Medicaid and residential facilities'
acceptance of private insurance and non-Medicaid public insurance
programs also increased in states that adopted Medicaid waivers.

Notably, the behavioral health waiver-one of several Section 1115
Medicaid waivers-has been approved at a higher rate

than all other current waivers.

While Medicaid waivers such as these can offer low-income people access
to much-needed health care, many still receive unequal treatment,
especially people of color. Our Elevating Voices series during Black
History Month continues with a powerful narrative by physician Vanessa
Grubbs about racism in kidney transplants
.
Her African American partner's wait for a kidney "mirrors the fact
that the median wait time for cadaveric (deceased donor) kidneys is
nearly twice as long for blacks as for whites," Grubbs explains.

If you want to listen to this Narrative Matters story, check out the
audio version read by the author
.

[link removed]

Podcast: What A $15 Minimum Wage Could Mean For Population Health

In the most recent episode of Health Affairs This Week, listen to Rob
Lott and Jeff Byers discuss how raising the minimum wage could impact
health.

Listen Here

Worthy Of Your Time

In The Digital Era, Payment Reform Is Key To Shaping A Modern Medicare
Program

Robert Horne and Lucia C. Savage

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