TY - JOUR
AU - A. R. Williams
AU - C. Rowe
AU - L. Minarik
AU - Z. Gray
AU - S. M. Murphy
AU - H. A. Pincus
A1 - 
AB - An empiric evidence base is lacking regarding the relationship between insurance status, payment source, and outcomes among patients with opioid use disorder (OUD) on telehealth platforms. Such information gaps may lead to unintended impacts of policy changes. Following the phase-out of the COVID-19 Public Health Emergency, states were allowed to redetermine Medicaid eligibility and disenroll individuals. Yet, financial barriers remain a common and significant hurdle for patients with OUD and are associated with worse outcomes. We studied 3842 patients entering care in 2022 at Ophelia Health, one of the nation's largest OUD telehealth companies, to assess associations between insurance status and 6-month retention. In multivariable analyses, in-network patients who could use insurance benefits were more likely to be retained compared with cash-pay patients (adjusted risk ratio [aRR]: 1.50; 95% CI: 1.40-1.62; P < .001). Among a subsample of 882 patients for whom more detailed insurance data were available (due to phased-in electronic health record updates), in-network patients were also more likely to be retained at 6 months compared with insured, yet out-of-network patients (aRR: 1.86; 95% CI: 1.54-2.23; P < .001). Findings show that insurance status, and specifically the use of in-network benefits, is associated with superior retention and suggest that Medicaid disenrollment and insurance plan hesitation to engage with telehealth providers may undermine the nation's response to the opioid crisis.
AD - Ophelia Health, Inc, New York, NY 10003, United States.; Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, United States.; Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, United States.
AN - 38450044
BT - Health Aff Sch
C5 - Opioids & Substance Use; Financing & Sustainability
CP - 3
DA - Mar
DO - 10.1093/haschl/qxae009
DP - NLM
ET - 20240130
IS - 3
JF - Health Aff Sch
LA - eng
N2 - An empiric evidence base is lacking regarding the relationship between insurance status, payment source, and outcomes among patients with opioid use disorder (OUD) on telehealth platforms. Such information gaps may lead to unintended impacts of policy changes. Following the phase-out of the COVID-19 Public Health Emergency, states were allowed to redetermine Medicaid eligibility and disenroll individuals. Yet, financial barriers remain a common and significant hurdle for patients with OUD and are associated with worse outcomes. We studied 3842 patients entering care in 2022 at Ophelia Health, one of the nation's largest OUD telehealth companies, to assess associations between insurance status and 6-month retention. In multivariable analyses, in-network patients who could use insurance benefits were more likely to be retained compared with cash-pay patients (adjusted risk ratio [aRR]: 1.50; 95% CI: 1.40-1.62; P < .001). Among a subsample of 882 patients for whom more detailed insurance data were available (due to phased-in electronic health record updates), in-network patients were also more likely to be retained at 6 months compared with insured, yet out-of-network patients (aRR: 1.86; 95% CI: 1.54-2.23; P < .001). Findings show that insurance status, and specifically the use of in-network benefits, is associated with superior retention and suggest that Medicaid disenrollment and insurance plan hesitation to engage with telehealth providers may undermine the nation's response to the opioid crisis.
PY - 2024
SN - 2976-5390
SP - qxae009
ST - Use of in-network insurance benefits is critical for improving retention in telehealth-based buprenorphine treatment
T1 - Use of in-network insurance benefits is critical for improving retention in telehealth-based buprenorphine treatment
T2 - Health Aff Sch
TI - Use of in-network insurance benefits is critical for improving retention in telehealth-based buprenorphine treatment
U1 - Opioids & Substance Use; Financing & Sustainability
U3 - 10.1093/haschl/qxae009
VL - 2
VO - 2976-5390
Y1 - 2024
ER -