Payment and billing strategies to support methadone take-home medication: Perspectives of financial leaders of opioid treatment program organizations in New York State

This study aims to understand OTP organizations’ experience with the newly created OTP bundled payment model in New York State as an alternative to the pre-existing per-service payment model during 2020–2023 to inform financing strategies to support and sustain practice changes. The study conducted semi-structured interviews with financial leaders and staff from OTP organizations in New York State. We developed a semi-structured interview guide to cover two major domains: 1) OTP organization’s experience with NYS Medicaid payment changes for OTPs during the COVID pandemic, and 2) OTP organization’s concerns (if any) regarding financial viability given the current design of the bundled payment. Purposeful sampling of OTP organizations based on their billing practices was supplemented by snowball sampling. Qualitative data from 12 interviews (with 11 OTP organizations and 1 trade organization) were analyzed with an integrated (inductive and deductive) approach to derive themes.