TY - JOUR
AU - A. Sharp
AU - A. Jones
AU - J. Sherwood
AU - O. Kutsa
AU - B. Honermann
AU - G. Millett
A1 - 
AB - OBJECTIVES: To assess the impact of the expansion of Medicaid eligibility in the United States on the opioid epidemic, as measured through increased access to opioid analgesic medications and medication-assisted treatment.     METHODS: Using Medicaid enrollment and reimbursement data from 2011 to 2016 in all states, we evaluated prescribing patterns of opioids and the 3 Food and Drug Administration-approved medications used in treating opioid use disorders by using 2 statistical models. We used difference-in-differences and interrupted time series models to measure prescribing rates before and after state expansions.     RESULTS: Although opioid prescribing per Medicaid enrollee increased overall, we observed no statistical difference between expansion and nonexpansion states. By contrast, per-enrollee rates of buprenorphine and naltrexone prescribing increased more than 200% after states expanded eligibility, while increasing by less than 50% in states that did not expand. Methadone prescribing decreased in all states in this period, with larger decreases in expansion states.     CONCLUSIONS:The Medicaid expansion enrolled a population no more likely to be prescribed opioids than the base Medicaid population while significantly increasing uptake of 2 drugs used in medication-assisted treatment.
BT - American Journal of Public Health
C5 - Financing & Sustainability; Healthcare Policy; Opioids & Substance Use
CP - 5
DO - 10.2105/AJPH.2018.304338
IS - 5
JF - American Journal of Public Health
N2 - OBJECTIVES: To assess the impact of the expansion of Medicaid eligibility in the United States on the opioid epidemic, as measured through increased access to opioid analgesic medications and medication-assisted treatment.     METHODS: Using Medicaid enrollment and reimbursement data from 2011 to 2016 in all states, we evaluated prescribing patterns of opioids and the 3 Food and Drug Administration-approved medications used in treating opioid use disorders by using 2 statistical models. We used difference-in-differences and interrupted time series models to measure prescribing rates before and after state expansions.     RESULTS: Although opioid prescribing per Medicaid enrollee increased overall, we observed no statistical difference between expansion and nonexpansion states. By contrast, per-enrollee rates of buprenorphine and naltrexone prescribing increased more than 200% after states expanded eligibility, while increasing by less than 50% in states that did not expand. Methadone prescribing decreased in all states in this period, with larger decreases in expansion states.     CONCLUSIONS:The Medicaid expansion enrolled a population no more likely to be prescribed opioids than the base Medicaid population while significantly increasing uptake of 2 drugs used in medication-assisted treatment.
PY - 2018
SP - 642
EP - 648
EP - 
T1 - Impact of Medicaid Expansion on Access to Opioid Analgesic Medications and Medication Assisted Treatment
T2 - American Journal of Public Health
TI - Impact of Medicaid Expansion on Access to Opioid Analgesic Medications and Medication Assisted Treatment
U1 - Financing & Sustainability; Healthcare Policy; Opioids & Substance Use
U2 - 29565661
U3 - 10.2105/AJPH.2018.304338
VL - 108
Y1 - 2018
ER -