Earlier this month, a newly formed healthcare alliance announced the Addiction Recovery Medical Home (ARMH) model, an Alternative Payment Model (APM) focused on providing patients with a long-term, comprehensive and integrated pathway to treatment and recovery. The new alliance, known as the Alliance for Recovery-Centered Addiction Health Services (the Alliance) includes members: Leavitt Partners, Facing Addiction with NCADD (The National Council on Alcoholism and Drug Dependence), and Remedy Partners.
The ARMH-APM is comprised of five key elements that represent its fundamental principles: payment, quality metrics, integrated treatment and recovery network, care recovery team, and treatment and recovery plan. The model was established in a commercial context and is initially targeting Medicaid managed care and large employer health plans, with high deference for adopting payers and providers to develop situation and population-specific applications.
The payment model is a multi-faceted approach that carves out financial resources for addiction treatment and recovery services, taking care to transcend three different, but often overlapping, phases of recovery (pre-recovery and stabilization, recovery initiation and active treatment, and community-based recovery management). The Alliance has also partnered with the National Committee for Quality Assurance (NCQA) to ensure the development of quality measures that more accurately reflect patient outcomes and performance.
Team-based care is a critical feature to managing any chronic disease. The ARMH-APM Care Recovery Team requires a care coordinator, a para-professionally trained peer recovery coach, behavioral health specialists, licensed counselors, and primary care professionals. The model also includes engagement protocols and requirements for this team’s engagement of the patient, focused on sustaining interaction and supports through the patient’s recovery journey. Further, the ARMH-APM has adopted a planning structure that includes 12 key recovery dimensions and advances specific guidelines on structuring treatment and recovery planning in collaboration with the patient.
The Alliance intends to pilot the ARMH model in at least two markets beginning in 2019. A rigorous research methodology will be developed and leveraged to study the effects of the model when compared to non-ARMH models of care and to study correlations between specific model tenets and the corresponding outputs.
“As addiction to alcohol and other drugs now impacts 1 in 3 households in America, we must urgently work to turn the tide on this health crisis,” said Greg Williams, a person in long-term recovery and Facing Addiction with NCADD’s Executive Vice President. “In late 2016, the U.S. Surgeon General issued the seminal report on Alcohol, Drugs, and Health: Facing Addiction In America. In this report, an urgent call to action for mainstream health systems to begin integration of substance use health services was afforded an entire chapter, and the industry leaders in this Alliance have responded in unprecedented fashion to that call.”
“The current payment models have failed to encourage the lasting recovery of the millions of people who are dealing with addiction,” said Chris Garcia, Chief Executive Officer at Remedy Partners. “The ARMH model offers the potential to refocus the energies of physicians and other care givers on what matters, helping the patient on the pathway to lasting recovery.”
“We see the most progress in healthcare when the clinical and the economic incentives are aligned. Treating substance use is tough enough, but without a thoughtful economic system in place, it is going to be very slow going,” said David Shulkin, MD, Former Secretary, U.S. Department of Veteran Affairs and Chairman, Remedy Partners National Advisory Board. “The addiction recovery medical home model of care aligns the interests of patients, providers and payers through a new risk-based payment methodology. Combined with the right therapeutic approaches to care, this payment system is the type of innovation that we need to accelerate our progress in dealing with the opioid crisis.”
“One of the greatest impediments to sustained recovery for patients is that various programs and treatment settings operate in isolation from one another with limitations in requisite information-sharing with other key parties,” said Anne Marie Polak, Senior Director at Leavitt Partners. “We are proud to say that the ARMH model is designed with the flexibility to meet providers and patients where they are, while honoring chronic disease management principles that will improve the coordination and application of care and recovery support.”