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Health Econ. 2018 Jan;27(1):76-101. doi: 10.1002/hec.3484. Epub 2017 Feb 21.

Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts.

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Department of Economics, Temple University, Philadelphia, PA, USA.
National Bureau of Economic Research, Cambridge, MA, USA.
Institute of Labor Economics (IZA), Bonn, North Rhine-Westphalia, Germany.
Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.


We examine the impact of the 2006 Massachusetts healthcare reform on substance use disorder (SUD) treatment facilities' provision of care. We test the impact of the reform on treatment quantity and access. We couple data on the near universe of specialty SUD treatment providers in the USA with a synthetic control method approach. We find little evidence that the reform lead to changes in treatment quantity or access. Reform effects were similar among for-profit and non-profit facilities. In an extension, we show that the reform altered the setting in which treatment is received, the number of offered services, and the number of programs for special populations. These findings may be useful in predicting the implications of major health insurance expansions on the provision of SUD treatment.


healthcare; healthcare reform; provider behavior; substance use disorders

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