Evidence map›Paper›PMID 36935064›Full record

ArticleJournal of substance use and addiction treatment2023

The role of health plans in addressing the opioid crisis: A qualitative study.

Margot Trotter Davis, Robert Bohler, Dominic Hodgkin, Greer Hamilton, Constance Horgan

Open access · greenAbstract read
In one paragraph

Article in Journal of substance use and addiction treatment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Next Steps in Ambulatory Stewardship.Infectious disease clinics of North America · 2023
    Review
  4. Financial Sustainability of Novel Delivery Models in Behavioral Health Treatment.The journal of mental health policy and economics · 2023
    Review
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

5 authors at 2 institutions in 1 country.

Margot Trotter DavisInstitute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, United States of America. Electronic address: margotd@brandeis.edu.
Robert BohlerInstitute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, United States of America.
Dominic HodgkinInstitute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, United States of America.
Greer HamiltonBoston University School of Social Work, United States of America.
Constance HorganInstitute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, United States of America.
Brandeis University · USUniversity School · US

Funding

MassHEAL - Reducing overdose deaths by 40% (2019-2023)UM1DA049412 · NIDA · BOSTON MEDICAL CENTER · PI SAMET, JEFFREY H. · 2019 to 2023
$82.9M
NIDA NIH HHS UM1 DA049412
6 · The paper itself

Abstract

introductionHealth plans are key players in substance use treatment in the United States, and the opioid crisis presents new challenges for them. This article is part of the HEALing Communities Study (HCS) funded by NIH, which seeks to facilitate communities' adoption of activities that might reduce overdose deaths, including overdose prevention education and naloxone distribution, medication for opioid use disorder, and safer opioid prescribing. We examine how health plans in one state (Massachusetts) are adapting to encourage and sustain activities that help communities to address opioid use disorder (OUD).

methodsWe conducted semi-structured interviews with managers of behavioral health services at eight health plans in Massachusetts that that have Medicare, Medicaid, and commercial lines of business. Two plans in this sample contract with a specialized behavioral health organization ("carve-out"). The interviewees also completed a survey on policies regarding access to treatment and opioid prescribing. Interviews were recorded and transcribed and analyzed using thematic analysis. Analysis of the data included intended influence of the policies at three levels: member level (micro), group or community level (meso), and system or institutional level (macro).

resultsAll health plans developed strategies to increase access to treatment for OUD, primarily through eliminating or decreasing cost-sharing, eliminating pre-authorization for MOUD, and increasing supply of providers. Health plans encourage qualified practitioners to offer MOUD, but most do not provide incentives or training. Identifying high risk populations is a focus of health plans in this sample. Naloxone is a covered benefit in all health plans, although with variation in monthly limits and cost-sharing. Most health plans take measures to influence opioid prescribing. Health plans' activities are predominately aimed at the micro (member) level with little ability to influence at the macro (wider system-level changes).

conclusionThis study provides insight into how health plans develop strategies to address the rise in OUD and fatal opioid overdoses, many of which are key in the HCS initiative. How active a role health plans play in addressing the opioid crisis varies, even within the insurance industry in one state (Massachusetts).

Indexed as

Analgesics, OpioidOpioid-Related DisordersAgedHumansMedicareNaloxoneOpioid EpidemicPractice Patterns, Physicians'United StatesAnalgesics, OpioidNaloxoneAccess to treatmentHealth plansHealth policyOpioid use disorderQualitative research

Identifiers

PMID36935064
PMCPMC10198902
OpenAlexW4327704332

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.