For CEOs and owners of addiction treatment centers, today’s behavioral health marketplace is competitive, metrics-driven, and undergoing rapid transformation. While most eyes are on payer contracts and census rates, a powerful growth opportunity remains overlooked: serving people with disabilities. Doing so isn’t just a matter of compliance or equity—it’s a path to increased revenue, patient satisfaction, and long-term leadership in the field.
The Largest Untapped Market in Addiction Care
Disability affects over 61 million Americans—making it the country’s largest minority group, yet one that is drastically underserved in substance use disorder (SUD) treatment. People with physical, sensory, cognitive, or psychiatric disabilities are at heightened risk for addiction due to chronic pain, medication exposure, social isolation, and limited preventive care. Research shows alarming gaps: people with disabilities have higher rates of substance use and are significantly less likely to access or complete SUD treatment than non-disabled peers.
For CEOs, this means that millions of potential clients—backed by Medicaid, Medicare, or private pay—are not being reached by conventional market strategies. On top of social need, there is clear demand, but access and engagement barriers remain stubbornly high. Facilities that pivot to explicitly include this group can expand their census, diversify payer sources, and build new referral partnerships.
Disability-Inclusive Programming: The ROI Case
When executives consider new investments, ROI is paramount. Fortunately, data shows that disability-accessible programming isn’t just ethical—it improves every major performance metric:
- Outcome Differentiation: Facilities that invest in universal design, disability-trained clinicians, and accessible digital infrastructure see higher rates of intake completion, increased treatment engagement, and elevated program completion. These metrics translate into stronger contracts with value-based payers and better negotiating positions with managed care organizations.
- Census and Reputation: Accessibility measures—such as flexible scheduling, in-home or virtual options, and cognitively adapted group therapy—draw in clients who were previously shut out. Word-of-mouth from these populations and their families also brings in new community referrals and strengthens relationships with healthcare partners and advocacy groups.
- Risk Mitigation: Addressing accessibility now reduces the likelihood of future legal disputes, bad publicity, and regulatory scrutiny. Instead, early adopters are seen as innovators and sector leaders.
Grantmaking bodies, public health agencies, and major insurers are actively seeking disability-inclusive providers for pilot projects, contract expansion, and thought leadership opportunities. Facilities that position themselves as accessible and outcome-focused often secure new funding and project invitations before competitors do.
CEOs & Owners: Leadership in Action
Ultimately, outcomes hinge on leadership. CEOs and owners set strategic priorities, allocate resources, and shape organizational culture. Here are three CEO-driven actions that link directly to measurable gains:
- Lead a Top-Down Audit & Redesign: Personally champion a facility-wide review of all client touchpoints, from marketing and inquiry through intake, programming, medication management, and aftercare. This isn’t just about ADA compliance—use tools and consultants who bring direct disability experience to uncover hidden barriers and generate investment recommendations. CEOs should allocate budgets for implementation and personally report progress to the board and public stakeholders.
- Forge Game-Changing Partnerships: Leverage executive influence to build formal MOUs with Centers for Independent Living, Medicaid transportation providers, and disability advocacy groups. These partners bring direct referrals, help streamline accommodations, and keep your programs ahead of market trends. CEOs who meet regularly with diverse community leaders gain faster insights and better anticipate shifts in demand and policy.
- Create Visibility Through Data & Storytelling: Make disability inclusion a public performance target. Add disability status to all core outcome metrics and stratify results by disability type. Report these metrics in annual reports and marketing materials—showing not just volume, but clinical excellence. CEOs should highlight client and partner success stories, positioning the facility as both a business leader and a force for social good.
Evidence-Based Examples That Work
- A mid-sized Midwest facility increased its monthly census by 22% within a year of launching a deaf-accessible treatment track and offering American Sign Language interpreters.
- An East Coast residential center’s investments in accessible shuttles and telehealth led to new grant awards from state health agencies and a contract expansion with Medicaid managed care plans.
- A national provider’s quarterly reporting on disability outcomes—shared on LinkedIn and in press releases—attracted major payer partnerships and national media coverage, distinguishing it from otherwise similar competitors.
Moving Beyond Compliance: Culture = Retention & Growth
It’s not just about the infrastructure. CEOs set the cultural tone. Make disability inclusion an explicit part of leadership messaging and staff development. Train supervisors to recognize accommodation needs and empower frontline teams to resolve barriers. Integrate peers with lived experience of disability into advisory boards and staff roles, ensuring that changes are continuous and grounded in real-world expertise.
Facilities that do this see not only retention gains among staff and clients, but also stronger loyalty, improved NPS (Net Promoter Scores), and better clinical outcomes—the very statistics that drive payer and partner decisions.
The Competitive & Social Edge
The addiction treatment landscape is shifting: payers, regulatory agencies, and client families are demanding more from treatment organizations. CEOs who recognize disability inclusion as a business strategy, not just a regulatory checkbox, will be the ones who thrive and shape the market’s future.
By expanding reach to the disability community, CEOs demonstrate innovation, operational excellence, and authentic care for those who’ve been too long excluded from high-quality SUD services. In a crowded sector, that’s the edge that ensures not just survival, but sustainable success and market leadership.
Now is the time to act: audit, partner, measure—and lead.
The market opportunity in serving people with disabilities in addiction treatment is substantial, but the potential loss of Medicaid recipients from the “Big Beautiful Bill” poses significant challenges that CEOs and owners must strategically address.
Medicaid is currently the largest payer for addiction treatment, especially for people with disabilities, who disproportionately rely on public insurance. The “Big Beautiful Bill” is projected to strip Medicaid coverage from over 1.6 million people in substance use disorder (SUD) treatment, with even bigger impacts likely for people with disabilities, as many will face new eligibility hurdles, frequent redeterminations, and increased out-of-pocket costs. Up to 16 million overall could lose coverage, with people with disabilities heavily represented among those affected.
However, the law does include an exemption for people actively engaged in addiction treatment—the SUD work requirement exemption—which could allow some Medicaid recipients with disabilities to retain coverage if they are enrolled in SUD programs. The complexity and administrative burden of proving eligibility for these exemptions, as well as state-by-state variation and the need for ongoing documentation, mean that not all impacted individuals will successfully navigate the new requirements. Providers are facing uncertainty about how to help clients qualify and maintain coverage, increasing operational strain
Ultimately, while the disability market remains critically important, the pool of Medicaid-covered clients could shrink, and administrative requirements for maintaining access will rise. Facilities focusing on disability inclusion will still have an advantage in attracting and retaining the remaining Medicaid population and may be able to expand into private-pay and grant-funded domains to offset losses. However, a major contraction in the Medicaid-dependent market is a real risk, underscoring the need for CEO-level advocacy, resource planning, and diversification of payer mixes now.
In summary, the market opportunity is still real but will require more proactive outreach, documentation, and potentially new models of service delivery to sustain census and impact under the new policy landscape.
Sources:
- https://www.kff.org/medicaid/how-will-the-2025-budget-reconciliation-affect-the-aca-medicaid-and-the-uninsured-rate/
- https://www.americanprogress.org/article/how-the-big-beautiful-bill-would-undermine-access-to-life-saving-substance-use-disorder-treatment/
- https://ccf.georgetown.edu/2025/06/26/one-big-beautiful-bill-act-winners-and-losers-in-the-medicaid-provisions/
- https://www.afscme.org/blog/americas-mental-health-crisis-would-worsen-if-the-budget-bill-becomes-law
- https://nashp.org/what-health-care-provisions-of-the-one-big-beautiful-bill-act-mean-for-states/
- https://www.americanprogress.org/article/the-truth-about-the-one-big-beautiful-bill-acts-cuts-to-medicaid-and-medicare/
- https://www.crossroadstreatmentcenters.com/news/how-medicaid-work-exemptions-could-reshape-the-sud-market/
- https://www.pwc.com/us/en/industries/health-industries/library/impact-of-obbba-on-us-health-system.html
- https://medicareadvocacy.org/impact-of-the-big-bill-on-medicare/
- https://www.kff.org/medicare/what-could-the-health-related-provisions-in-the-reconciliation-bill-mean-for-older-adults/
- https://www.disabilityrightsca.org/latest-news/disability-rights-california-appalled-by-cuts-to-medicaid-in-one-big-beautiful-bill-act
- https://www.congress.gov/crs-product/R48569
- https://www.kff.org/medicaid/tracking-the-medicaid-provisions-in-the-2025-budget-bill/
- https://ccf.georgetown.edu/2025/05/27/medicaid-and-chip-cuts-in-the-house-passed-reconciliation-bill-explained/
- https://www.himss.org/news-center/breaking-down-h-r-1-healthcare-impacts-of-the-one-big-beautiful-bill/
- https://www.ballardspahr.com/insights/alerts-and-articles/2025/08/impact-of-the-one-big-beautiful-bill-act-on-the-life-sciences-industry
- https://updates.apaservices.org/update-on-proposed-cuts-to-medicaid-funding
- https://www.crowell.com/en/insights/client-alerts/president-trumps-one-big-beautiful-bill-makes-changes-to-medicaid
- https://www.milbank.org/quarterly/opinions/medicaid-cuts-will-heighten-the-us-mental-health-and-substance-use-crisis/
- https://bhbusiness.com/2025/07/03/one-big-beautiful-bill-clears-congress-making-feared-medicaid-reforms-a-reality/
