Open AccessOvercoming policy and financing barriers to integrated buprenorphine and HIV primary care.
Author(s) -
Bruce R. Schackman,
Joseph O. Merrill,
Dennis McCarty,
Jeffrey Levi,
Christine Lubinski
Publication year - 2006
Publication title -
pubmed
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.44
H-Index - 336
ISSN - 1058-4838
DOI - 10.1086/508190
Subject(s) - buprenorphine , confidentiality , medicine , substance abuse , health care , heroin , addiction , addiction medicine , business , nursing , finance , drug , opioid , economic growth , psychiatry , political science , economics , receptor , law
Treatment for substance abuse and human immunodeficiency virus (HIV) infection historically have come from different providers, often in separate locations, and have been reimbursed through separate funding streams. We describe policy and financing challenges faced by health care providers seeking to integrate buprenorphine, a new treatment for opioid dependence, into HIV primary care. Regulatory challenges include licensing and training restrictions imposed by the Drug Addiction Treatment Act of 2000 and confidentiality regulations for alcohol and drug treatment records. Potential responses include the development of local training programs and electronic medical records. Addressing the complexity of funding sources for integrated care will require administrative support, up-front investments, and federal and state leadership. A policy and financing research agenda should address evidence gaps in the rationales for regulatory restrictions and should include cost-effectiveness studies that quantify the "value for money" of investments in integrated care to improve health outcomes for HIV-infected patients with opioid dependence.