Wake Forest IMPOWR Dissemination Education and Coordination Center (IDEA-CC)

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Project Summary The NIH HEAL IMPOWR program focuses on developing integrated assessment and treatment pathways for people with chronic pain and opioid use disorder. The WF IMPOWR Dissemination Education and Coordination Center (IDEA-CC) provides the support and data infrastructure to develop, as well as the clinical, educational, and technical domain expertise to achieve the core principles of the IMPOWR program. This supplemental proposal builds on the goals of the parent grant to develop our understanding of how to translate the findings of the IMPOWR network interventions into clinical practice. Medicaid is the leading insurer for both substance use treatment and mental health in the US but has a wide range of coverage and reimbursement because of the local policy variation. While the IMPOWR network's studies are determining clinical utility, we plan to investigate longitudinal Medicaid coverage and reimbursement for a subset of states in the IMPOWR program for behavioral and integrative health interventions. Our long-term goal is to improve the treatment of co-morbid CP and OUD. We will assess Medicaid policy driven reimbursement for behavioral health and counseling services for OUD treatment according to provider type, as well as details around treatment specifics. The overall hypothesis is that the wide variety of Medicaid policy coverage and reimbursement creates gaps in care that prevent evidence-based care from being implemented. This hypothesis will be tested through our aim: Identifying Medicaid policies for coverage and reimbursement of behavioral and integrative health services for the treatment of OUD and CP. We will assess Medicaid policy driven reimbursement for behavioral health and counseling services for OUD treatment according to provider type (e.g., peer counselors, licensed counselors, social workers, and psychologists), as well as details around treatment specifics (setting, individual vs. group, # of sessions). Additionally, we will assess integrative therapies from IMPOWR interventions when available under policy. This proposal will identify both where IMPOWR study interventions could be implemented under existing policies and where Medicaid pilot studies may be required. Leveraging our ability to engage and analyze different payment and reimbursement data, this proposal will support, amplify, and create momentum for the IMPOWR network's findings across the HEAL network and scientific community. IDEA-CC will support NIH HEAL's goal to enhance the impact of existing treatments for co- occurring OUD and CP. The knowledge gained through this supplemental proposal will enable the scientific community to support understanding of what interventions can be adopted due to coverage and work toward Medicaid pilot projects for treatments that have demonstrated benefit in IMPOWR programs but may not yet be covered by payers.