Addiction recovery is more than abstinence—our metrics should be too

Value-based payment is reshaping U.S. healthcare by linking reimbursement to patient outcomes. Approximately 70% of health plans anticipate growth in value-based payment models over the next two years, with nearly 45% of their healthcare payments in 2024 already using value-based or alternative payment arrangements.1 In the context of treating opioid use disorder (OUD), common reimbursement metrics include reimbursement for negative urine drug screens and low hospital readmission rates.2 We focus on OUD because that is where value-based payment is expanding fastest and the stakes are most acute, though the argument extends to substance use disorders broadly.