Rethinking Medicare’s Bundled Payment Model For Opioid Treatment Programs Haiden A. Huskamp Alisa B. Busch Dominic Hodgkin Christopher Tompkins Richard G. Frank April 1, 2026

https://www.healthaffairs.org/content/forefront/rethinking-medicare-s-bundled-payment-model-opioid-treatment-programs The SUPPORT for Patients and Communities Act of 2018 is a comprehensive law intended to combat the ongoing opioid epidemic in part by expanding access to evidence-based opioid use disorder (OUD) treatment, including Food and Drug Administration (FDA)-approved medications that treat OUD. Fewer than one in five people with OUD receive medications for opioid use disorder (MOUD) in part due to difficulty in finding a local prescriber. Opioid treatment programs (OTPs) are strictly regulated providers of OUD care and the only facilities in the US authorized to dispense methadone, a Schedule II controlled substance, for the treatment of OUD. To expand MOUD options available to Medicare beneficiaries with OUD, Section 2005 of the SUPPORT Act called for the creation of a Medicare benefit for services provided by OTPs. In this Forefront article, we examine the design of the payment system for OTPs in the benefit, and we propose some directions for modifying the policy to better align the incentives with the goal of expanding access to OUD treatment services.