Taking a business approach to ensure that every American has access to treatment based upon proven research.
Approximately 21 million Americans have a substance use disorder (SUD). Of them, only one in ten receives any form of treatment. Even worse, for those who do receive treatment, it is often delivered without the use of evidence-based practice.1,2
Gary Mendell discussed the Task Force's groundbreaking work on CNBC's Squawk Box.
Decades of scientific evidence shows that SUDs can be effectively treated, with recurrence rates no higher than those for other chronic illnesses such as diabetes, or hypertension and that treatment reduces the risk of overdose, improves outcomes, and saves costs.
The Substance Use Disorder Treatment Task Force (the Task Force) has been assembled to move the addiction treatment system to high quality, evidence-based care and significantly improve patient outcomes.
A body of research and literature exists that documents the flaws and barriers of the current treatment system and provides evidence and recommendations to improve the quality of SUD treatment nationally; however, comprehensive progress has not been made in this direction. This Task Force has been formed to bridge research and practice, and ensure implementation of the most up-to-date findings that increase access to quality treatment for SUDs and improve patient outcomes.
The Task Force is a public-private group, co-chaired by Gary Mendell, CEO and Founder of Shatterproof, and Dr. Thomas McLellan, PhD, Founder of the Treatment Research Institute and former Deputy Director of the White House Office of National Drug Control Strategy. The Task Force is engaging a variety of stakeholders and the foremost experts on addiction treatment within four areas: consumers, providers, payers, and licensors.
“Sustained reduction of cardinal symptoms related to SUD, improved general health and function, and the ability to self-manage the disease and avoid relapses.”
National Principles of Care for SUD Treatment
Scientific evidence shows that SUDs can be managed with the same effectiveness as other chronic diseases; however, the SUD treatment system has not kept pace with advances in science and evidence. This is largely due to separation from the mainstream healthcare system, policy barriers, and stigma. The Shatterproof National Principles of Care© for Substance Use Disorder Treatment (the Principles), are the first step of the Task Force’s work to change the standard treatment for SUDs and ensure implementation of the evidence-based best practices.
The Principles represent core concepts included in The Surgeon General’s Report on Alcohol, Drugs, and Health, which are supported by multiple, rigorous research studies in multiple settings and with multiple populations. The findings have been reviewed and approved for accuracy by over 300 independent scientists, and have been accepted and endorsed by all five of the federal agencies most responsible for addiction policy (SAMHSA, NIDA, NIAAA, CDC, FDA, CMS).
National Principles of Care for Substance Use Disorder Treatment
Science shows that these best practices improve treatment outcomes and save lives.Learn More
Payer Adoption of Principles of Care
Health insurers, like the treatment system more broadly, have generally lagged in aligning their practices with evidence-based treatment, meaning individuals with an SUD may not have access to the best treatment, and in some cases may even be directed to sub-optimal care.
By signing-on to the Principles, payers have stepped forward and will begin to work with the Task Force to implement strategies to incentivize care that is of the highest quality, and remove existing barriers to this type of treatment.
Provider Engagement & Education
Ensuring that high-quality care is covered and incentivized by health insurance is only one step. But access to the best medical treatment for patients with an SUD will not improve without simultaneously engaging providers across healthcare systems.
The Task Force will work with provider groups to develop and implement strategies that support delivery of care that aligns with the National Principles of Care for SUD Treatment.
This involves identifying barriers for current providers, changing practices of those that may not currently provide care that aligns with the Principles, and incentivizing new providers to enter this space given the dire need.
Consistent with the Donabedian model for examining healthcare quality, Shatterproof is working to identify structure, process, and outcome measures aligning with the Principles of Care. Like approaches used in other healthcare sectors, the measures will be used to inform provider report cards.
These report cards, which will function as a treatment “rating system,” are being designed to:
- drive quality improvement among the provider community
- serve as a resource for referral sources
- serve as a tool for insurers and states in making payment and network decisions
- inform consumer decisions when seeking care
Consumer Education & Stigma Reduction
A large amount of misinformation about addiction treatment exists in the public domain. The Task Force will work to promote evidence-based information on quality SUD treatments and their outcomes, and to reduce the shame and stigma associated with this disease and its treatment.
SUDs are chronic, relapsing conditions—not moral failings. They can and should be managed in the same way as other chronic conditions within the healthcare system. However, too many individuals affected by an SUD do not know what “good” treatment consists of, let alone where to find it. Worse even is the stigma around treatment itself, such as a misconception that medication-assisted treatment (MAT) simply replaces one drug with another. These inaccurate messages increase barriers to scientifically proven, highly effective medical interventions.
While there is no “one-size-fits-all” model for treatment of SUDs, individuals should receive a personalized biopsychosocial treatment plan based on an assessment and should have access to the appropriate level of care for their disease severity.
The Task Force’s goal is that all individuals affected by an SUD, whether personally or through a mutual connection, can identify and demand the most effective treatment options.
Michael Botticelli, Executive Director of the Grayken Center for Addiction Medicine at Boston Medical Center, and former Director of Office of National Drug Control Policy
Charles Ingoglia, Senior Vice President, Public Policy and Practice Improvement at the National Council of Behavioral Health
Thomas McLellan, founder and chairman of the Treatment Research Institute, and former Deputy Director of the Office of National Drug Control Policy under President Obama
Gary Mendell, founder and CEO of Shatterproof, a national non-profit dedicated to ending the devastation associated with addiction
Penny S. Mills, Executive Vice President/CEO, American Society of Addiction Medicine
John O’Brien, Senior Consultant at Technical Assistance Collaborative, Inc., former senior advisor for healthcare financing at the U.S. Department of Health and Human Services
Daniel Polsky, Executive director of the Leonard Davis Institute of Health Economics. LDI is the leading university institute dedicated to improving health and health care through data-driven, policy-focused research.
Betty Tai, Director, Center for the Clinical Trials Network, National Institute on Drug Abuse
Jay Butler, President, Association of State and Territorial Health Officials, and Chief Medical Officer, Alaska Department of Health and Social Services
Harold L. Paz, MD, MS
Executive Vice President and Chief Medical Officer, Aetna
Andrea Gelzer, MD
SVP and Corporate Chief Medical Officer, AmeriHealth Caritas Family of Companies
Charles Gross, PhD
Vice President, Behavioral Health, Anthem, Inc.
Sherry Dubester, MD, MS
Executive Vice President and Chief Medical Officer, Beacon Health Options
Katherine Hobbs Knutson, MD MPH
Director of Behavioral Health, Blue Cross Blue Shield of North Carolina
Bruce Nash, MD, MBA
Chief Physician Executive, Blue Cross Blue Shield of Massachusetts
Amit Shah, MD
Chief Medical Officer, CareOregon
Vice President, Behavioral Health, CareSource
Ken Yamaguchi, M.D.
Executive Vice President, Chief Medical Officer, Centene Corporation
President US Business Segments and Specialty Solutions, Cigna
Christopher D. Palmieri
President and Chief Executive Officer, Commonwealth Care Alliance
Senior Vice President, Envolve Health
Charles DeShazer, MD
Senior Vice President and Chief Medical Officer, Highmark Health Plan
Mary Ann Christopher
Vice President, Clinical Operations and Transformation, Horizon Blue Cross Blue Shield of New Jersey
Karen Amstutz, MD
Chief Medical Officer, Magellan Health
Hal Gooch, MD
National Medical Director, MHI Clinical Policy & Services, Molina Healthcare, Inc.
Richard J. Migliori
Chief Medical Officer, UnitedHealth Group
James Schuster, MD, MBA
Chief Medical Officer, Medicaid, Special Needs and Behavioral Services; VP, Behavioral Integration, UPMC Insurance Division
Mark Leenay, MD
Chief Medical Officer, WellCare