Medicaid Unwinding Linked To Drop In Opioid Use Disorder Treatment

The extremity of pandemic-era enrollment enhancements for Medicaid was associated pinch a emergence successful nan number of group ending medicine curen for opioid usage disorder, arsenic good arsenic a alteration successful nan number of group opening specified treatment, according to a caller RAND study.

While immoderate group who disenrolled from Medicaid whitethorn person recovered different methods to salary for supplier treatment, nan wide number of those initiating and continuing medicine curen for opioid usage upset declined successful nan six months aft Medicaid unwinding began. The changes were top successful states that person had nan largest disenrollments.

The study tracked curen episodes of nan opioid usage upset medicine buprenorphine from 2021 to 2023 arsenic pandemic-era Medicaid enrollment protections were phased out. The study authors opportunity nan findings person relevance fixed nan caller national authorities expected to consequence successful 10 cardinal Americans losing their Medicaid wellness sum by 2034.

The study is published successful nan Journal of Addiction Medicine.

These findings are peculiarly salient astatine a clip erstwhile argumentation changes are expanding uncertainty astir Medicaid sum for galore individuals. To prolong advancement nan federation has made against nan opioid overdose crisis, it is basal to guarantee that individuals who tin use from life-saving medicine proceed to person it."

Bradley D. Stein, study's corresponding writer and elder expert argumentation interrogator astatine RAND

Medication curen is nan most-effective curen for group battling addiction to fentanyl and different opioids, pinch buprenorphine being 1 commonly prescribed curen for individuals pinch opioid usage disorder. Medicaid covers astir 40% of curen for Americans pinch opioid usage disorder.

More than 25 cardinal Americans person disenrolled from Medicaid arsenic a consequence of Medicaid unwinding -- nan process successful which states resumed normal Medicaid enrollment procedures aft a play of continuous sum mandated during nan COVID-19 pandemic.

To analyse nan domiciled that unwinding played successful medicine curen for opioid usage disorder, RAND researchers examined prescriptions dispensed astatine unit pharmacies successful each 50 states and nan District of Columbia to place buprenorphine curen episodes from Jan. 1, 2021 to Dec. 31, 2023.

About 45% of nan buprenorphine curen episodes were paid for by Medicaid, 18% by commercialized insurance, 11% by Medicare, 11% by discount cards/vouchers, and 6% were cash-pay. Approximately 27% of curen episodes were successful high-unwinding states, 41% successful moderate-unwinding states, and 31% successful low-unwinding states.

On average, location were 3% much curen episodes paid for by Medicaid that ended aft unwinding began arsenic compared to earlier unwinding. In states pinch nan top unwinding, nan percent quality was much than double that successful states pinch mean aliases debased levels of unwinding.

There were 2.6% less caller curen episodes paid for by Medicaid successful nan six months aft unwinding compared to six months earlier unwinding. There was a important 3.9% alteration successful caller curen episodes paid for by Medicaid successful states pinch nan top unwinding, compared to a 2.4% alteration successful states pinch mean unwinding, and a 2% alteration successful states pinch nan smallest magnitude of unwinding.

Changes successful curen episodes paid for by Medicaid look not to beryllium wholly offset by changes successful reimbursement from different sources, specified arsenic individuals losing Medicaid paying out-of-pocket for buprenorphine aliases obtaining commercialized insurance.

"These changes were associated pinch an summation successful nan number of Medicaid enrollees stopping buprenorphine curen and a alteration successful enrollees opening it," said Rachel K. Landis, study coauthor and argumentation interrogator astatine RAND. "Consistent pinch investigation connected full buprenorphine fills, effects were top successful states pinch nan top Medicaid disenrollment."

Research reported successful this property merchandise was supported by nan National Institute connected Drug Abuse of nan National Institutes of Health nether grant number P50DA04635108. The contented is solely nan work of nan authors and does not needfully correspond nan charismatic views of nan National Institutes of Health. Support for nan study was besides provided by nan Foundation for Opioid Response Efforts (FORE).