Policy and Payment Factors Influencing Adoption of Low-Barrier Buprenorphine Treatment

What policy and payment factors do opioid use disorder (OUD) treatment practitioners believe influence buprenorphine prescribing?In this qualitative study of 28 clinicians and staff from buprenorphine programs, participants reported that insurance coverage, reimbursement, payer policies, and regulatory requirements were major drivers of clinical practice. Many programs relied on supplemental funding to sustain care, and participants described payment barriers, such as prior authorizations and attendance-based reimbursement, that limited timely and individualized treatment.These findings suggest that policy barriers that limit buprenorphine access and retention persist, and adapting reimbursement and regulatory frameworks to align with low-barrier, evidence-based care could improve patients’ ability to access OUD treatment.

Corresponding Author: Margaret Lowenstein, MD, MPhil, MSHP, Perelman School of Medicine, University of Pennsylvania, 3600 Civic Center Blvd, 7th Floor, Philadelphia, PA 19104 (margaw@pennmedicine.upenn.edu).

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