Researchers at University of California Have Published New Data on Implementation Science (Translating Medicaid policy into practice: policy implementation strategies from three US states’ experiences enhancing substance use disorder treatment): Science – Implementation Science

2022 JAN 25 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New study results on implementation science have been published. According to news originating from the University of California by NewsRx correspondents, research stated, “Despite the important upstream impact policy has on population health outcomes, few studies in implementation science in health have examined implementation processes and strategies used to translate state and federal policies into accessible services in the community. This study examines the policy implementation strategies and experiences of Medicaid programs in three US states that responded to a federal prompt to improve access to evidence-based practice (EBP) substance use disorder (SUD) treatment.”

The news journalists obtained a quote from the research from University of California: “Three US state Medicaid programs implementing American Society of Addiction Medicine (ASAM) Criteria-driven SUD services under Section 1115 waiver authority were used as cases. We conducted 44 semi-structured interviews with Medicaid staff, providers and health systems partners in California, Virginia, and West Virginia. Interviews were triangulated with document review of state readiness and implementation plans. The Exploration, Preparation, Implementation, Sustainment Framework (EPIS) guided qualitative theme analysis. The Expert Recommendations for Implementing Change and Specify It criteria were used to create a taxonomy of policy implementation strategies used by policymakers to promote providers’ uptake of statewide EBP SUD care continuums. Four themes describe states’ experiences and outcomes implementing a complex EBP SUD treatment policy directive: (1) Medicaid agencies adapted their inner/outer contexts to align with EBPs and adapted EBPs to fit their local context; (2) enhanced financial reimbursement arrangements were inadequate bridging factors to achieve statewide adoption of new SUD services; (3) despite trainings, service providers and managed care organizations demonstrated poor fidelity to the ASAM Criteria; and (4) successful policy adoption at the state level did not guarantee service providers’ uptake of EBPs. States used 29 implementation strategies to implement EBP SUD care continuums. Implementation strategies were used in the Exploration (n=6), Preparation (n=10), Implementation (n=19), and Sustainment (n=6) phases, and primarily focused on developing stakeholder interrelationships, evaluative and iterative approaches, and financing.”

According to the news reporters, the research concluded: “This study enhances our understanding of statewide policy implementation outcomes in low-resource, public healthcare settings. Themes highlight the need for additional pre-implementation and sustainment focused implementation strategies. The taxonomy of detailed policy implementation strategies employed by policymakers across states should be tested in future policy implementation research.”

For more information on this research see: Translating Medicaid policy into practice: policy implementation strategies from three US states’ experiences enhancing substance use disorder treatment. Implementation Science, 2022,17(1):1-14. (Implementation Science - http://www.implementationscience.com/). The publisher for Implementation Science is BMC.

A free version of this journal article is available at https://doi.org/10.1186/s13012-021-01182-4.

Our news editors report that additional information may be obtained by contacting Erika L. Crable, Child and Adolescent Services Research Center, Department of Psychiatry, University of California, San Diego. Additional authors for this research include Allyn Benintendi, David K. Jones, Alexander Y. Walley, Jacqueline Milton Hicks, Mari-Lynn Drainoni.

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