Observational studyDrug and alcohol dependence2015
States' implementation of the Affordable Care Act and the supply of physicians waivered to prescribe buprenorphine for opioid dependence.
Observational study in Drug and alcohol dependence, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 31 citations in OpenAlex.
- Physicians' satisfaction with providing buprenorphine treatment.Addiction science & clinical practice · 2019Trial
- Exploring the Association of State Policies and the Trajectories of Buprenorphine Prescriber Patient Caseloads.Substance abuse · 2023Article
- The effect of Medicaid expansion on state-level utilization of buprenorphine for opioid use disorder in the United States.Drug and alcohol dependence · 2022Article
- Growing racial/ethnic disparities in buprenorphine distribution in the United States, 2007-2017.Drug and alcohol dependence · 2021Article
- Buprenorphine waiver uptake among nurse practitioners and physician assistants: The role of existing waivered prescriber supply.Journal of substance abuse treatment · 2020Article
- Association Between Medicaid Expansion and Rates of Opioid-Related Hospital Use.JAMA internal medicine · 2020Article
- Understanding the increase in opioid overdoses in New Hampshire: A rapid epidemiologic assessment.Drug and alcohol dependence · 2020Article
- Differences in Availability and Use of Medications for Opioid Use Disorder in Residential Treatment Settings in the United States.JAMA network open · 2020Article
- Adoption of the 275-patient buprenorphine treatment waiver for treating opioid use disorder: A state-level longitudinal analysis.Substance abuse · 2020Observational
- Article
- The Affordable Care Act and Opioid Agonist Therapy for Opioid Use Disorder.Psychiatric services (Washington, D.C.) · 2019Article
- Physicians as Mediators of Health Policy: Acceptance of Medicaid in the Context of Buprenorphine Treatment.The journal of behavioral health services & research · 2019Article
- Why aren't physicians prescribing more buprenorphine?Journal of substance abuse treatment · 2017Article
- Does a Free Office Visit Affect Primary Care-Seeking Behavior? A Study of New Exchange Health Plan Enrollees in Mississippi.American health & drug benefits · 2017Article
- Buprenorphine physician supply: Relationship with state-level prescription opioid mortality.Drug and alcohol dependence · 2017Observational
- Nonmedical Use of Prescription Opioids among Pregnant U.S. Women.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
- Perceived Impacts of the Affordable Care Act: Perspectives of Buprenorphine Prescribers.Journal of psychoactive drugsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAlthough the Affordable Care Act (ACA) is anticipated to affect substance use disorder (SUD) treatment, its impact on the supply of physicians waivered to treat opioid dependence with buprenorphine has not been considered. This study examined whether states more supportive of ACA, meaning those that had opted to expand Medicaid and establish a state-based health insurance exchange, experienced greater growth in physician supply than less supportive states.
methodsBuprenorphine physician supply, including total physician supply, supply of 30-patient physicians, and supply of 100-patient physicians per 100,000 state residents, was measured from June 2013 to May 2015. State characteristics were drawn from multiple secondary sources, with states categorized as ACA-supportive, ACA-hybrid (where states either expanded Medicaid or established a state-based exchange), or ACA-resistant (where states took neither action). Mixed effects regression was used to estimate state-level growth curves to test whether rates of growth varied by states' approaches to implementing ACA.
resultsThe supply of waivered physicians grew significantly over the two-year period. Rates of growth were significantly lower in ACA-hybrid and ACA-resistant states relative to growth in ACA-supportive states. Average buprenorphine physician supply at baseline varied by region, the percentage of residents covered by Medicaid, and the supply of specialty SUD treatment programs.
conclusionsThis study found a positive impact of the ACA on growth in the supply of buprenorphine-waivered physicians in US states. Future research should address whether the ACA affects the number of patients receiving buprenorphine, Medicaid spending, and the quality of treatment services delivered.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.