April 16, 2013; MSN Money

According to this AP article, some in addiction services are worrying that, once the Affordable Care Act goes into effect, there may be a resultant increase in the number of people seeking treatment for substance abuse issues that could result in an onslaught of demand that the centers will not be able to meet. The degree of increase—perhaps doubling, says the author—will be affected by the decisions states make about expanding their programs and whether or not people opt to take advantage of their new eligibility for insurance.

An article in the Atlanta Journal-Constitution suggests that only one in ten addicts in Washington State can currently access services because they lack health insurance and private treatment is too pricy. This article estimates that approximately a half million addicted people now go unserved, and that up to 166,000 of them may become eligible for coverage next year if the state expands Medicaid coverage. However, Jane Beyer, assistant secretary for behavioral health and service integration at the state’s Department of Social and Health Services is not panicking, because she says the field is acting in creative and entrepreneurial ways to prepare to meet demand. She cites the new collaborations between rural hospitals and substance abuse treatment providers as examples. “We are really trying to encourage creative contractual relationships,” Beyer said.

In New Hampshire, Abby Bourgeois, director of the New Hampshire Alcohol and Other Drug Service Providers Association, says that providers in the state have been struggling as a result of recent budget cuts but that they will have to ramp up quickly to divine how to best structure the new system which also requires a shift from grant funding to fee-for-service.

“Medicaid expansion and the Affordable Care Act really provide some immense opportunities for providers and the people they serve. But I think with that opportunity also come challenges. As an association and as a network of providers, we’re really working hard to help our agencies build the capacity they need to respond to the expected changes.”

“There’s a good understanding that it is a work in progress, but we’re trying to do the best we can with what we know, and we do at least have the scope and resources to get the agencies started down the road to be doing this in the future,” she said. “You have to be optimistic about it. Of course we understand there are going to be challenges, but we’ll take those in stride and learn from them and work through them.”

Apparently, private equity firms, in anticipation of this increased demand, are increasing their investments in addiction treatment centers. NPQ would like to hear what our readers are doing that is related to meeting the projected demand. Do you believe it will occur? What kinds of new relationships are you forging, and to what ends? Do you think that any part of this shift will lessen or improve the quality of services?—Ruth McCambridge