In 2015, 20.8 million people aged 12 years or older (7.8 percent of the United States population) had a substance use disorder (SUD) in the previous year. Approximately 75 percent of this group, or 15.7 million Americans, had an alcohol use disorder, 2.0 million had a prescription opioid use disorder (OUD), and about 0.6 million had a heroin use disorder. Even though evidence-based SUD treatments are effective, rates of treatment receipt are quite low. Only about 48 percent of patients who enter SUD treatment actually complete it. One measure of treatment receipt is the Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) performance measure, which is commonly reported by health plans and used by health systems and Medicaid and Medicare programs .Chapter 1 examines how these factors affect health plan performance on the IET measures for both commercial and Medicaid health plans and how initiation and engagement may be improved. According to the Centers for Disease Control, more than 115 people in the U.S. die after overdosing on opioids every day. In 2017, over 72,000 Americans died from drug overdoses, overall. It is clear that we need safe and effective recovery options to combat this epidemic to ensure that people have the opportunity to get the help they need. One popular option is known as a sober living home as discussed in chapter 2.