Fact Sheets

Value-Based Care for Addiction Treatment

Caron's Model for Substance Use Disorder Treatment Works

To advance our mission of Recovery For Life, we developed insurance partnerships to increase access to high quality care and provide treatment to more people in residential care at Caron Pennsylvania. The initial pilot study of a reimbursement model with IBC (Independence Blue Cross) proved Caron's patient-centric model for substance use disorder (SUD) treatment works. Since then, we've expanded our network of insurance providers and collected data from two independent studies from leading insurance providers, including IBC.

The results are promising.

For starters, with more insurance contracts, Caron admitted and treated more patients year-over-year and achieved high rates of recovery. Collectively, the recent data shows Caron's high rate of recovery (92.4%) at 90-days post-treatment, which conversely reflects its low rate of readmission (7.6%) by patients.

[Note: While these numbers may seem lower than the initial study, this data accounts for an increased population size of two insurance carriers. The number of readmissions is proportional to the larger number of patients, and continues to gain momentum each year.]

Caron's approach on quality, interdisciplinary treatment protocols with a median inpatient stay of 25 days, combined with a long-term disease management plan, is successful.

Why is value-based care important?

A value-based, or outcomes-driven, reimbursement model supports the treatment of SUD as a chronic, treatable brain disease because it prioritizes:

  • the use of evidence-based practices
  • medically appropriate modalities
  • an appropriate length of stay (clinically/medically determined)

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