Publications · 2024
Access to Treatment Before and After Medicare Coverage of Opioid Treatment Programs
Health Affairs Scholar , 2(6):qxae076 , 2024 · doi:10.1093/haschl/qxae076
Overview
After Medicare began covering opioid treatment programs in 2020, the share of OTPs accepting Medicare jumped from 21% in 2018 to 81% by 2021. County-level access improved overall, with somewhat larger gains in counties with higher non-White populations. Availability of ancillary services such as HIV/AIDS education, employment services, and comprehensive mental health assessment did not increase, suggesting that Medicare coverage expanded enrollment access without expanding the underlying scope of services available to beneficiaries.
Abstract
Since January 2020, Medicare has covered opioid use disorder (OUD) treatment services at opioid treatment programs (OTPs), the only outpatient settings allowed to dispense methadone for treating OUD. This study examined policy-associated changes in Medicare acceptance and the availability of four OUD treatment services (ongoing buprenorphine, HIV/AIDS education, employment services, and comprehensive mental health assessment), by for-profit status, and county-level changes in Medicare-accepting-OTPs access, by sociodemographic characteristics (racial composition, poverty rate, and rurality). Using data from the 2019-2022 National Directory of Drug and Alcohol Abuse Treatment Facilities, we found Medicare acceptance increased from 21.31% in 2018 to 80.76% in 2021. The availability of the four treatment services increased, but no increases were significantly associated with Medicare coverage. While county-level OTP access significantly improved, counties with higher rates of non-White residents experienced an additional average increase of 0.86 Medicare-accepting-OTPs (95% CI, 0.05–1.67) compared to those without higher rates of non-White populations. Overall, Medicare coverage was associated with improved OTP access, not ancillary services.
Topics
- Medicare
- opioid treatment program
- methadone
- OUD treatment
- health equity
- ancillary services
- policy evaluation
How to cite
Liu R, Beetham T, Newton H, Busch S. Access to Treatment Before and After Medicare Coverage of Opioid Treatment Programs. Health Affairs Scholar, 2(6):qxae076; 2024. doi:10.1093/haschl/qxae076
Show BibTeX
@article{liu2024accessto,
title = {{Access to Treatment Before and After Medicare Coverage of Opioid Treatment Programs}},
author = {Liu, R. and Beetham, T. and Newton, H. and Busch, S.},
journal = {Health Affairs Scholar},
year = {2024},
volume = {2},
number = {6},
pages = {qxae076},
doi = {10.1093/haschl/qxae076},
url = {https://doi.org/10.1093/haschl/qxae076},
abstract = {Since January 2020, Medicare has covered opioid use disorder (OUD) treatment services at opioid treatment programs (OTPs), the only outpatient settings allowed to dispense methadone for treating OUD. This study examined policy-associated changes in Medicare acceptance and the availability of four OUD treatment services (ongoing buprenorphine, HIV/AIDS education, employment services, and comprehensive mental health assessment), by for-profit status, and county-level changes in Medicare-accepting-OTPs access, by sociodemographic characteristics (racial composition, poverty rate, and rurality). Using data from the 2019-2022 National Directory of Drug and Alcohol Abuse Treatment Facilities, we found Medicare acceptance increased from 21.31% in 2018 to 80.76% in 2021. The availability of the four treatment services increased, but no increases were significantly associated with Medicare coverage. While county-level OTP access significantly improved, counties with higher rates of non-White residents experienced an additional average increase of 0.86 Medicare-accepting-OTPs (95% CI, 0.05–1.67) compared to those without higher rates of non-White populations. Overall, Medicare coverage was associated with improved OTP access, not ancillary services.},
keywords = {Medicare; opioid treatment program; methadone; OUD treatment; health equity; ancillary services; policy evaluation}
}