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Addiction Treatment Access Increases Under Medicaid Expansion, Study Shows

Addiction Treatment Access Increases Under Medicaid Expansion, Study Shows

posted by: Nicole Hovey date: May 21, 2019 category: Blog comments: Comments Off on Addiction Treatment Access Increases Under Medicaid Expansion, Study Shows

A new study suggests that Medicaid expansion can give low-income individuals better access to buprenorphine for opioid addiction. One concern about expanding Medicaid under the Affordable Care Act (ACA) is that it will give patients increased access to addicting opioid medications. The new study results, published in Health Affairs, could help alleviate these concerns.

Addiction Treatment and Medicaid Study Findings

West Virginia is at the epicenter of a national opioid crisis, with a 2016 fatal opioid overdose rate of 43.4 per 100,000 population—more than triple the US average.

Researchers looked at claims data from 2014 to 2016 among people enrolled in the West Virginia Medicaid expansion program under the Affordable Care Act. The researchers wanted to examine trends in treatment for opioid use disorder (OUD) in this population. Such patients may have had limited access to OUD treatment before the expansion.

About 5.5 percent of all enrollees included in the study were diagnosed with OUD each year. From 2014 to 2016, the monthly prevalence of OUD diagnoses nearly tripled. About one-third of those patients diagnosed with OUD filled buprenorphine orders in early 2014. This rate increased to more than 75 percent by late 2016.

The mean annual duration of filled buprenorphine increased from 161 days to 185 days in 2014 to 2016. Researchers found that most patients who received buprenorphine also received counseling and drug testing. This aligns with FDA recommendations for medication-assisted treatment for OUD.

State Medicaid Expansion and Addiction Treatment

The new study focused solely on data from West Virginia, since it has experienced some of the most serious consequences of the national opioid crisis. In 2016, the fatal opioid overdose rate in West Virginia was more than three times the national average, at 43.4 per 100,000 people.
As OUD and other addictions persist throughout the nation, other states and researchers are also considering the potential impact of Medicaid expansion.

Researchers writing in the Journal of General Internal Medicine looked at trends in fatal drug overdoses deaths in Arizona, Maine, and New York. These three states had all expanded Medicaid program eligibility before implementation of the ACA. Results show that rates of drug overdose deaths rose less sharply in these states compared with all states that did not expand Medicaid.

A study published in the Journal of Health Economics in 2018 found that “aggregate opioid admissions to specialty treatment facilities increased 18 percent in expansion states, most of which involved outpatient medication-assisted treatment (MAT).” The results also showed that opioid admissions from Medicaid beneficiaries rose 113 percent. These effects were greatest in expansion states with comprehensive MAT coverage.

This year, Virginia became the 33rd state to expand Medicaid, which included expanded access to addiction treatment options. Virginia Commonwealth University examined the prevalence of SUD among uninsured Virginia residents and newly eligible Medicaid members. The university reports that opioid prescriptions have declined among members, but a growing number are receiving co-prescriptions for the opioid antagonist naloxone. This is also part of a statewide effort to curb the opioid crisis.

Addiction Treatment and Behavioral Health EHR Solutions

If you’re a behavioral health provider in a state that has enacted Medicaid expansion, you may be seeing increased demand. BestNotes EHR, created for behavioral health and addiction treatment organizations, can help you streamline your services so you can improve care, track patient outcomes, and increase practice revenue. Contact us today to learn more, and even schedule a free demo.

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