Impact of Medication-Assisted Treatment for Opioid Addiction on Medicaid Expenditures and Health Services Utilization Rates in Vermont.
In the face of increasing rates of overdose deaths, escalating health care costs, and the tremendous social costs of opioid addiction, policy makers are asked to address the questions of whether and how to expand access to treatment services. In response to an upward trend in opioid abuse and adverse outcomes, Vermont is investing in statewide expansion of a medication-assisted therapy program delivered in a network of community practices and specialized treatment centers (Hub & Spoke Program). This study was conducted to test the rationale for these investments and to establish a pre-Hub & Spoke baseline for evaluating the additive impact of the program. Using a serial cross-sectional design from 2008 to 2013 to evaluate medical claims for Vermont Medicaid beneficiaries with opioid dependence or addiction (6158 in the intervention group, 2494 in the control group), this study assesses the treatment and medical service expenditures for those receiving medication-assisted treatment compared to those receiving substance abuse treatment without medication. Results suggest that medication-assisted therapy is associated with reduced general health care expenditures and utilization, such as inpatient hospital admissions and outpatient emergency department visits, for Medicaid beneficiaries with opioid addiction. For state Medicaid leaders facing similar decisions on approaches to opioid addiction, these results provide early support for expanding medication-assisted treatment services rather than relying only on psychosocial, abstinence, or detoxification interventions.
Vermont Blueprint for Health, NOB 1 South, 280 State Drive, Waterbury, VT 05671, USA. Electronic address: marykate.mohlman@vermont.gov.
Mary Kate
MK
Mohlman
Vermont Blueprint for Health, NOB 1 South, 280 State Drive, Waterbury, VT 05671, USA.
Beth
B
Tanzman
Onpoint Health Data, 254 Commercial Street, Suite 257, Portland, ME 04101, USA.
Karl
K
Finison
Onpoint Health Data, 254 Commercial Street, Suite 257, Portland, ME 04101, USA.
Melanie
M
Pinette
Vermont Blueprint for Health, NOB 1 South, 280 State Drive, Waterbury, VT 05671, USA.
Craig
C
Jones
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000191:economics / Q000592:standards; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000191:economics / Q000534:rehabilitation; D014481:United States; D014707:Vermont; D055815:Young Adult
Addiction; MAT; Medicaid; Medication-assisted treatment; Opioid