TY - JOUR
KW - Analgesics, Opioid/therapeutic use
KW - Buprenorphine/therapeutic use
KW - Humans
KW - Methadone/therapeutic use
KW - North Carolina
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy
KW - Primary Health Care
KW - Specialization
KW - United States
KW - buprenorphine
KW - health care providers
KW - Health Policy
KW - Medicaid
KW - medication assisted treatment
KW - Nonsubstance related additions
KW - patient care
KW - Pharmaceuticals
KW - Quality Improvement
KW - quality measurement
KW - Quality of Care
KW - Substance use disorder
KW - Methadone
KW - opioid use disorder
AU - A. K. Gertner
AU - A. G. Robertson
AU - B. J. Powell
AU - H. Jones
AU - P. Silberman
AU - M. E. Domino
A1 - 
AB - In response to rising numbers of opioid overdose deaths, primary care providers have been called on to play a greater role in delivering buprenorphine treatment for opioid use disorder. However, policy makers and providers have raised concerns that expanding treatment access may reduce treatment quality and that primary care providers are not well equipped to deliver buprenorphine treatment. We investigated two research questions in response to these concerns: How did buprenorphine treatment use and quality change in North Carolina Medicaid from 2014 to 2017, and how did buprenorphine treatment quality differ between primary care providers and specialists in North Carolina Medicaid during this period? We measured buprenorphine treatment quality as patients' retention in treatment and providers' adherence to treatment guidelines. We found that the number of enrollees receiving medication treatment for opioid use disorder increased substantially, but the percentage of enrollees with the disorder receiving treatment remained low. The quality of buprenorphine treatment increased during the study period, and primary care providers provided care of comparable or higher quality compared with that of other providers. Treatment quality for buprenorphine treatment is improving, but there remains room for improvement in both use and quality. Our results support the role of primary care providers in expanding treatment for opioid use disorder.
AD - Alex K. Gertner (alex_gertner@med.unc.edu) is an MD/PhD candidate in health policy and management at the University of North Carolina at Chapel Hill, in Chapel Hill, North Carolina.; Allison G. Robertson is an associate professor in the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, in Durham, North Carolina.; Byron J. Powell is an assistant professor at the Brown School, Washington University in St. Louis, in St. Louis, Missouri.; Hendree Jones is a professor of obstetrics and gynecology at the University of North Carolina School of Medicine, in Chapel Hill, North Carolina.; Pam Silberman is a professor of health policy and management at the University of North Carolina at Chapel Hill.; Marisa Elena Domino is a professor of health policy and management at the University of North Carolina at Chapel Hill and the Cecil G. Sheps Center for Health Services Research.
BT - Health affairs (Project Hope)
C5 - Education & Workforce; Financing & Sustainability; Opioids & Substance Use
CP - 8
DO - 10.1377/hlthaff.2019.01559
IS - 8
JF - Health affairs (Project Hope)
LA - eng
M1 - Journal Article
N2 - In response to rising numbers of opioid overdose deaths, primary care providers have been called on to play a greater role in delivering buprenorphine treatment for opioid use disorder. However, policy makers and providers have raised concerns that expanding treatment access may reduce treatment quality and that primary care providers are not well equipped to deliver buprenorphine treatment. We investigated two research questions in response to these concerns: How did buprenorphine treatment use and quality change in North Carolina Medicaid from 2014 to 2017, and how did buprenorphine treatment quality differ between primary care providers and specialists in North Carolina Medicaid during this period? We measured buprenorphine treatment quality as patients' retention in treatment and providers' adherence to treatment guidelines. We found that the number of enrollees receiving medication treatment for opioid use disorder increased substantially, but the percentage of enrollees with the disorder receiving treatment remained low. The quality of buprenorphine treatment increased during the study period, and primary care providers provided care of comparable or higher quality compared with that of other providers. Treatment quality for buprenorphine treatment is improving, but there remains room for improvement in both use and quality. Our results support the role of primary care providers in expanding treatment for opioid use disorder.
PY - 2020
SN - 1544-5208; 0278-2715; 0278-2715
SP - 1395
EP - 1404
EP - 
T1 - Primary Care Providers And Specialists Deliver Comparable Buprenorphine Treatment Quality
T2 - Health affairs (Project Hope)
TI - Primary Care Providers And Specialists Deliver Comparable Buprenorphine Treatment Quality
U1 - Education & Workforce; Financing & Sustainability; Opioids & Substance Use
U2 - 32744950
U3 - 10.1377/hlthaff.2019.01559
VL - 39
VO - 1544-5208; 0278-2715; 0278-2715
Y1 - 2020
Y2 - Aug
ER -