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TEAMKY Demonstration

Approval Period: January 1, 2025 through December 31, 2029

Page 105 of 155 Although there are many parts to the SUD implementation plan, the primary focus of the demonstration is to improve access to and utilization of treatment for SUD, and accordingly, the evaluation will focus on this aspect of the demonstration.

A.3. Population Groups Impacted by the Demonstration

The population group affected by this demonstration will be Kentucky Medicaid beneficiaries with a substance use disorder.

B. EVALUATION QUESTIONS AND HYPOTHESES

B.1. Overview

Given the focus of the demonstration on increasing access to SUD treatment, the evaluation will concentrate on the areas most likely to be affected by demonstration initiatives, namely: 1. availability of provider services and capacity of treatment facilities available to Medicaid beneficiaries; 2. utilization of SUD services in residential facilities, particularly facilities affected by the IMD exclusion; and 3. utilization of SUD treatment services, especially medication-assisted treatment (MAT) and methadone as part of MAT.

As secondary outcomes, the evaluation will also examine selected opioid-related metrics, including overdose deaths, ED and hospital admissions for SUD, and self-reported survey measures of health and substance use. Per CMS technical specifications, the evaluation will also analyze Medicaid SUD expenditures.

B.2. Driver Diagram

The driver diagram—depicting the relationship between the purpose of the demonstration, the primary drivers that contribute directly to realizing that purpose, and the secondary drivers necessary to achieve the primary drivers—is shown in Figure 1.