Funding Sources for MOUD Programs

Funding is a critical resource for the sustainability of a rural program providing medication for opioid use disorder (MOUD). A program must consider what funding is available to ensure it can continue operating and providing MOUD. Two sources of funding programs should consider are reimbursement for services and grants.

Reimbursement for Services

A rural MOUD program can plan for financial sustainability by seeking payment and reimbursement for the services it provides. MOUD programs can receive reimbursement by billing private and public medical insurance providers, including Medicaid. These reimbursements can go directly towards funding the program activities and services. Reimbursement policies and approaches will differ by treatment provider, payer (private or public), and state.

There are different reimbursement approaches to consider for a rural MOUD program. Medicaid payments may occur through fee for service (FFS), bundled payments, and value-based payment models. Medicaid payments for medication-assisted treatment (MAT) may also occur through a Medicaid health home model. Reimbursement rates and policies may differ by state. Because payment policies differ by location and frequently change, a rural MOUD program should have staff dedicated to determining specific rules for reimbursement. It may also help to maintain written policies and procedures for billing.

Programs should consider what services are reimbursable and the reimbursement rate for those services. For example, telehealth and in-person services may have different reimbursement rates. Services that programs should consider for reimbursement include laboratory testing, case management, care coordination, and reimbursement for co-located services such as primary care visits and sexually transmitted infection (STI) testing.

Grants

Grant funding for an MOUD program may be in the form of a one-time or multi-year grant period. Grant funding can help programs reach their goals and may also provide programs with technical assistance to improve their practices. Grants may have specific requirements, such as developing a sustainability plan, which can help organizations start to plan for the future of their program. However, grant funding often has an end date after which a program will need to find and secure another grant or additional funding source.

For additional information regarding funding for rural substance use disorder programs, see Funding Sources in the Rural Prevention and Treatment of Substance Use Disorders Toolkit.

Resources to Learn More

Brandeis Opioid Resource Connector: Funding Agencies
Website
Provides a curated list of agencies offering funding resources focused on the opioid crisis.
Organization(s): Opioid Policy Research Collaborative, Brandeis University Heller School for Social Policy and Management

Medicaid Coverage of Medication-Assisted Treatment for Alcohol and Opioid Use Disorders and of Medication for the Reversal of Opioid Overdose
Document
Provides information on Medicaid coverage and financing for medication-assisted treatment (MAT) for opioid use and alcohol disorders. Discusses program requirements for reimbursement, limitations on specific medications, drug utilization strategies for treatment and overdose, state and federal policies and regulations, and models for effective treatment.
Organization(s): Substance Abuse and Mental Health Services Administration (SAMHSA)
Date: 11/2018