Delivery and payment reform in Massachusetts: substance use disorder treatment organizations’ perspectives

Background The Affordable Care Act and many states’ health-care reforms present opportunities and challenges for the substance use disorder (SUD) treatment system. These reforms foster the implementation of new payment and delivery system models that emphasize care coordination and make providers more responsible for patients’ clinical management and costs. Bundled payments, a predetermined fee or budget that includes the prices of a group of services that would typically treat an episode of care in a defined period of time, are considered one of the most promising new payment models. Bundled payments for SUD treatment have the potential to improve care coordination, implementation of evidence-based practices, and engagement in outpatient treatment; reduce readmissions to detox; make care more patientcentered; and cover treatment services that are not traditionally reimbursed. The objective of this study was to obtain SUD treatment organizations’ perspectives on health-care reform and the design of bundled payments for SUD treatment.