For individuals with substance use disorder (SUD), mental illness or co-occurring mental illness and SUD conditions, peer support services (PSS) connect them with health and community resources to help initiate recovery.
PSS is defined as specialized assistance delivered by a person in recovery from a serious mental illness, substance use, or co-occurring mental and substance use condition. These services are considered evidence based by Centers for Medicare & Medicaid Service (CMS), and are currently reimbursable as part of state Medicaid plans in at least 37 states.
Optum has established PSS in 21 states, with the common goal among these programs being to:
- Reduce readmit rates
- Increase community tenure
- Demonstrate measurable impacts on member recovery and wellness
The results have been notable, with improved health outcomes and effective service utilization across programs that include PSS.