ArticleHealth services research2020
The effect of Medicaid expansion on use of opioid agonist treatment and the role of provider capacity constraints.
Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 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
13 citing papers in PubMed.
- Medicaid expansion and medications to treat opioid use disorder in outpatient specialty care from 2010 to 2020.Journal of substance use and addiction treatment · 2025Article
- Spatial inequities in access to medications for treatment of opioid use disorder highlight scarcity of methadone providers under counterfactual scenarios.PLoS computational biology · 2024Article
- Association of Medicaid expansion with health insurance, unmet need for medical care and substance use disorder treatment among people who inject drugs in 13 US states.Addiction (Abingdon, England) · 2024Article
- State Policy and the Breadth of Buprenorphine-Prescriber Networks in Medicaid Managed Care.Medical care research and review : MCRR · 2023Article
- National Trends in Buprenorphine Treatment for Opioid Use Disorder From 2007 to 2018.Substance abuse · 2023Observational
- Opioid Use Disorder Practice by Licensure Category in North Carolina.North Carolina medical journal · 2023Article
- Medicaid Managed Care: Access To Primary Care Providers Who Prescribe Buprenorphine.Health affairs (Project Hope) · 2022Article
- The effect of Medicaid expansion on state-level utilization of buprenorphine for opioid use disorder in the United States.Drug and alcohol dependence · 2022Article
- Evaluating buprenorphine prescribing and opioid-related health outcomes following the expansion the buprenorphine waiver program.Journal of substance abuse treatment · 2022Article
- Effects of the ACA on Health Care Coverage for Adults With Substance Use Disorders.Psychiatric services (Washington, D.C.) · 2021Article
- Retention in the Austrian opioid agonist treatment system: a national prospective cohort study.Harm reduction journal · 2021Article
- Medication for opioid use disorder treatment and specialty outpatient substance use treatment outcomes: Differences in retention and completion among opioid-related discharges in 2016.Journal of substance abuse treatment · 2020Article
- The effect of Medicaid expansion on use of opioid agonist treatment and the role of provider capacity constraints.Health services research · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveTo determine the effect of Medicaid expansion on the use of opioid agonist treatment for opioid use disorder (OUD) and to examine heterogeneous effects by provider supply and Medicaid acceptance rates. DATA SOURCES: Yearly state-level data on methadone dispensed from opioid treatment programs (OTPs), buprenorphine dispensed from OTPs and pharmacies, number of OTPs and buprenorphine-waivered providers, and percent of OTPs and physicians accepting Medicaid. STUDY
designThis study used difference-in-differences models to examine the effect of Medicaid expansion on the amount of methadone and buprenorphine dispensed in states between 2006 and 2017. Interaction terms were used to estimate heterogeneous effects. Sensitivity analyses included testing the association of outcomes with Medicaid enrollment and state insurance rates. PRINCIPAL
findingsThe estimated effects of Medicaid expansion on buprenorphine and methadone dispensed were positive but imprecise, meaning we could not rule out negative or null effects of expansion. The estimated associations between state insurance rates and dispensed methadone and buprenorphine were centered near zero, suggesting that improvements in health coverage may not have increased OUD treatment use. The effect of Medicaid expansion was larger in the states with the most waivered providers compared to states with the fewest waivered providers. In the states with the most waivered providers, the average estimated effect of expansion on buprenorphine dispensed was 12 kg/y, enough to treat about 7500 individuals. We did not find evidence that the effect of expansion was consistently modified by OTP concentration, OTP Medicaid acceptance, or physician Medicaid acceptance.
conclusionsGains in health coverage may not be sufficient to increase OUD treatment, even in the context of high treatment need. Provider capacity likely limited Medicaid expansion's effect on buprenorphine dispensed. Policies to increase buprenorphine providers, such as ending the waiver requirement, may be needed to ensure coverage gains translate to treatment access.
Indexed as
Identifiers
What OpenQuestion holds
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.