People with opioid use disorder (OUD) have complex needs and characteristics that often make effective, continuous addiction treatment a challenge. Individuals with OUD are disproportionately impacted by co-occurring chronic conditions, higher rates of social service utilization, and higher rates of involvement in the criminal justice system. Furthermore, OUD care is financed and delivered separately from other medical care, making it hard for individuals with OUD to access and remain engaged in treatment due to care complexity and a lack of care coordination. As the major payer for OUD treatment in the United States, Medicaid programs are uniquely positioned to enact innovative delivery system reforms that can significantly improve OUD treatment outcomes. Most state Medicaid OUD care delivery innovations can be categorized into two main areas: (1) health homes and (2) warm handoffs and care transitions. This brief provides an overview of these approaches and offers recent examples from state Medicaid programs based on findings from an OUD policy inventory of nine state Medicaid programs that have been substantially impacted by the opioid epidemic and participate in the Medicaid Outcomes Distributed Research Network (MODRN).
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