Medicaid Expanding to Cover Inpatient Treatment

Thursday, October 31, 2019 | By admin

Over the last five years, thousands of Colorado residents have died at the hands of overdose. For those on the outside looking in, receiving help and going to treatment seems like a fairly easy process. However, all over the country, millions of low-income Americans are being turned away from inpatient substance abuse treatment due to an inability to pay. 

In response to this massive gap of underserved Americans, Medicaid as announced it will be expanding access to inpatient treatment for its subscribers. This is good news that brings hope to thousands of Colorado residents who will now have access to quality inpatient treatment.

Getting Sober in Outpatient 

For those who may be unaware, there is a big difference between inpatient and outpatient treatment facilities. While the lines can sometimes be blurred when comparing the length of participation or the structure of the program, the main difference is:

  • Inpatient treatment requires the individual to stay at the facility, 24/7
  • A minimum of 6-8 hours of therapy per day
  • An average of 21-60 day program

Outpatient treatment facilities tend to be more day programs, where individuals are able to live on their own or in a separate housing and are required to attend a certain amount of hours of group and individual therapy per week. 

The difference here lies in how encompassing addiction can be. Since addiction literally takes over the mental, emotional, and often physical systems of an individual, inpatient treatment combined with a 12 step program has been proven to have the highest success rate in long term sobriety. 

The key comes in the physical and mental separation from the individual and the participation in an environment that promotes recovery. When people who are struggling to get clean and sober stay surrounded by the same old people, places, and things that surrounded them in their addiction, it can be easy to fall into relapse. 

medicaid inpatient treatment

This is why it is monumental that Medicare will be expanding inpatient treatment options to their many alcoholics and addicts around the country. The low-income population is often the hardest hit, and most often overlooked when it comes to receiving quality health care. This expanded access to inpatient treatment can literally mean the difference between life and death for thousands of Americans. 

The Fallbacks

As with any major change to the insurance policy and healthcare coverage, there are some potential setbacks and downsides. Expanding access to inpatient treatment sounds easy in theory, but in reality, it involves millions of dollars in taxpayer money, opening doors to facilities in rural areas. 

Not to mention, individual states such as Colorado will have to apply to Medicaid for approval for these expanded services. If all goes according to the plan, the inpatient treatment policy could go into effect by July. 

Already, the state of Colorado has gathered $5 million to funnel into opening inpatient treatment facilities in different pockets of the state. As it stands right now, the state has stretched its resources thin in regards to substance abuse treatment. According to Stephanie Allred, Axis Health Systems senior clinical director, even Coloradans who are privately insured and of a higher income level can struggle to find a bed. 

Through a combination of poor mental health coverage in insurance policies and a shortage of quality inpatient treatment facilities, many of the state residents are still not getting access to the help they need. 

Currently, the organization Allred works for, Axis Health Systems, provides mental and behavioral care to residents in the state, but she says they do not expect that Axis will be adding residential or inpatient treatment centers to their services.

How to Solve the Problem

As was previously stated, Colorado has gathered $5 million with the intention of creating more access to inpatient treatment facilities for Colorado residents. This means anything from harm reduction programs to building more facilities. For now, Allred and Lauren Snyder, the state policy director of Mental Health Colorado, have resorted to sending Coloradans to out of state facilities. 

Although the major cities of Colorado are bustling and well-populated, a large majority of the state is more rural. The concern now is, if the money goes towards building new facilities, and Medicaid doesn’t grant the expanded coverage to Colorado, will there be enough people to be able to fill the beds? 

As of right now, it seems to be that the decision to face the overdose deaths in the state lies solely in the hands of the crusaders who have been walking the trenches already, and, Medicaid. Unfortunately, policy changes in any shape or size take time, deliberation, and lots of paperwork. 

Yes, if Colorado is approved for the Medicaid expansion, it could help save thousands from the depths of addiction. However, July is a very long time to wait to act. 

Luckily, over the last year, the overdose death rate HAS dropped in the state, thanks to expanded education, medication-assisted treatment, and increased public awareness. 

If the Medicaid bill is passed, Colorado and many other states who are approved will hopefully be in for a real turn around. 

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