Evidence map›Paper›PMID 35977217›Full record

ArticleJAMA health forum2022

Performance Metrics of Substance Use Disorder Care Among Medicaid Enrollees in New York, New York.

Margarita Alegría, Irene Falgas-Bague, Marie Fukuda, Jenny Zhen-Duan, Cole Weaver, Isabel O'Malley, Timothy Layton, Jacob Wallace, Lulu Zhang, Sheri Markle and 10 more

Open access · goldAbstract read
In one paragraph

Article in JAMA health forum, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 7 institutions in 1 country.

Margarita AlegríaDisparities Research Unit, Massachusetts General Hospital, Boston.
Irene Falgas-BagueDisparities Research Unit, Massachusetts General Hospital, Boston.
Marie FukudaDisparities Research Unit, Massachusetts General Hospital, Boston.
Jenny Zhen-DuanDisparities Research Unit, Massachusetts General Hospital, Boston.
Cole WeaverDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
Isabel O'MalleyDisparities Research Unit, Massachusetts General Hospital, Boston.
Timothy LaytonDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
Jacob WallaceYale School of Public Health, New Haven, Connecticut.
Lulu ZhangDisparities Research Unit, Massachusetts General Hospital, Boston.
Sheri MarkleDisparities Research Unit, Massachusetts General Hospital, Boston.
Charles NeighborsGrossman School of Medicine, New York University, New York.
Pat LincourtNew York State Office of Alcoholism and Substance Abuse Services, Albany, New York.
Shazia HussainNew York State Office of Alcoholism and Substance Abuse Services, Albany, New York.
Marc ManseauGrossman School of Medicine, New York University, New York.
Bradley D SteinRAND Corporation, Pittsburgh, Pennsylvania.
Nancy RigottiDepartment of Medicine, Harvard Medical School, Boston, Massachusetts.
Sarah WakemanDepartment of Medicine, Harvard Medical School, Boston, Massachusetts.
Martha KaneDepartment of Psychiatry, Harvard Medical School, Boston, Massachusetts.
A Eden EvinsDepartment of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Thomas McGuireDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
Massachusetts General Hospital · USHarvard University · USNew York State Office of Alcoholism and Substance Abuse Services · USNew York State Office of Mental Health · USNew York University · USRAND Corporation · USYale New Haven Health System · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
The Impact of Medicaid Plans on Access to and Quality of SUD TreatmentR01DA044526 · NIDA · MASSACHUSETTS GENERAL HOSPITAL · PI ALEGRIA, MARGARITA · 2018 to 2020
$1.6M
NCATS NIH HHS UL1 TR001863NIDA NIH HHS R01 DA044526
6 · The paper itself

Abstract

Importance: There is limited evaluation of the performance of Medicaid managed care (MMC) private plans in covering substance use disorder (SUD) treatment. Objective: To compare the performance of MMC plans across 19 indicators of access, quality, and outcomes of SUD treatment. Design Setting and Participants: This cross-sectional study used administrative claims and mandatory assignment to plans of up to 159 016 adult Medicaid recipients residing in 1 of the 5 counties (boroughs) of New York, New York, from January 2009 to December 2017 to identify differences in SUD treatment access, patterns, and outcomes among different types of MMC plans. Data from the latest years were received from the New York State Department of Health in October 2019, and analysis began soon thereafter. Approximately 17% did not make an active choice of plan, and a subset of these (approximately 4%) can be regarded as randomly assigned. Exposures: Plan assignment. Main Outcomes and Measures: Percentage of the enrollees achieving performance measures across 19 indicators of access, process, and outcomes of SUD treatment. Results: Medicaid claims data from 159 016 adults (mean [SD] age, 35.9 [12.7] years; 74 261 women [46.7%]; 8746 [5.5%] Asian, 73 783 [46.4%] Black, and 40 549 [25.5%] White individuals) who were auto assigned to an MMC plan were analyzed. Consistent with national patterns, all plans achieved less than 50% (range, 0%-62.1%) on most performance measures. Across all plans, there were low levels of treatment engagement for alcohol (range, 0%-0.4%) and tobacco treatment (range, 0.8%-7.2%), except for engagement for opioid disorder treatment (range, 41.5%-61.4%). For access measures, 4 of the 9 plans performed significantly higher than the mean on recognition of an SUD diagnosis, any service use for the first time, and tobacco use screening. Of the process measures, total monthly expenditures on SUD treatment was the only measure for which plans differed significantly from the mean. Outcome measures differed little across plans. Conclusions and Relevance: The results of this cross-sectional study suggest the need for progress in engaging patients in SUD treatment and improvement in the low performance of SUD care and limited variation in MMC plans in New York, New York. Improvement in the overall performance of SUD treatment in Medicaid potentially depends on general program improvements, not moving recipients among plans.

Indexed as

MedicaidSubstance-Related DisordersAdultCross-Sectional StudiesFemaleHealth Services AccessibilityHumansNew YorkUnited States

Identifiers

PMID35977217
PMCPMC9250047
OpenAlexW4283754685

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.