Health care costs have increased rapidly in the last decade. These cost increases have caused significant changes in the financing and delivery of health care services, especially in public programs. Many States are revamping their current Medicaid system and enrolling Medicaid recipients into managed care system in an attempt to control the escalating costs of Medicaid. This change could greatly affect methadone treatment and subject participants and providers to capitated financing, prior treatment authorization, and utilization reviews. The literature review revealed that successful methadone maintenance treatment reduces participants’ illicit drug use and criminal involvement and improves their employment and health. However, the effectiveness of methadone maintenance treatment is contingent upon the participant’s retention in the program. Individuals who prematurely leave methadone treatment have a high probability of reverting to pretreatment drug abuse, crime, and employment status. Findings suggest that policies that limit treatment access or the duration of methadone maintenance treatment may increase societal cost in the long run. 50 references (Author abstract modified)