Format

Send to

Choose Destination
Med Care. 2017 Apr;55(4):336-341. doi: 10.1097/MLR.0000000000000703.

Impact of Medicaid Expansion on Medicaid-covered Utilization of Buprenorphine for Opioid Use Disorder Treatment.

Author information

1
*Department of Health Management & Policy, University of Kentucky College of Public Health, Lexington, KY †Department of Health Policy & Management, Emory University Rollins School of Public Health, Atlanta, GA.

Abstract

BACKGROUND:

Buprenorphine has been proven effective in treating opioid use disorder. However, the high cost of buprenorphine and the limited prescribing capacity may restrict access to this effective medication-assisted treatment for opioid use disorder.

OBJECTIVE:

To examine whether Medicaid expansion and physician prescribing capacity may have impacted buprenorphine utilization covered by Medicaid.

RESEARCH DESIGN:

We used a quasi experimental difference-in-differences design to compare the pre-post changes in Medicaid-covered buprenorphine prescriptions and buprenorphine spending between the 26 states that implemented Medicaid expansions under the Affordable Care Act in 2014 and those that did not.

SUBJECTS:

All Medicaid enrollees in the expansion states and the nonexpansion and late-expansion states.

MEASURES:

Quarterly Medicaid prescriptions for buprenorphine and spending on buprenorphine from the Centers for Medicare and Medicaid Services Medicaid Drug Utilization files 2011 to 2014.

RESULTS:

State implementation of Medicaid expansions in 2014 was associated with a 70% increase (P<0.05) in Medicaid-covered buprenorphine prescriptions and a 50% increase (P<0.05) in buprenorphine spending. Physician prescribing capacity was also associated with increased buprenorphine utilization.

CONCLUSIONS:

Medicaid expansion has the potential to reduce the financial barriers to buprenorphine utilization and improve access to medication-assisted treatment of opioid use disorder. Active physician participation in the provision of buprenorphine is needed for ensuring that Medicaid expansion achieves its full potential in improving treatment access.

PMID:
28296674
DOI:
10.1097/MLR.0000000000000703
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center