title: Geographic Disparities in Availability of Opioid Use Disorder Treatment for Medicaid Enrollees.
abstract: To examine county-level geographic variation in treatment admissions among opioid treatment programs (OTPs) that accept Medicaid in the continental United States.
  
  
  
  Data come from the 2012 National Survey of Substance Abuse Treatment Services.
  
  
  
  We used local measures of spatial autocorrelation (LISA) analysis to identify (1) clusters of counties with higher and lower than average rates of opioid use disorders and (2) clusters of counties with higher and lower than average treatment admissions among OTPs that accept Medicaid, adjusting for county population size.
  
  
  
  Our results reveal several clusters of counties with higher than average rates of opioid use disorder (OUD) and lower than average treatment admissions among OTPs that accept Medicaid. These clusters are highly concentrated in the Southeast region of the country and include Arkansas, Kentucky, Louisiana, Mississippi, and Tennessee.
  
  
  
  Medicaid enrollees in areas in the Southeast have the largest gaps between county-level OUD rates and estimated county-level capacity for treatment, as measured by county-level total treatment admissions among OTPs that accept Medicaid. Policy makers should consider strategies to increase the availability of OTPs with the capacity to serve Medicaid enrollees.
authors.affiliation: Department of Public Administration and Policy, School of Public and International Affairs, University of Georgia, Athens, GA.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Abraham
authors.affiliation: College of Social Work, University of South Carolina, Hamilton College, Columbia, SC.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Andrews
authors.affiliation: Department of Sociology and Anthropology, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC.
authors.forename: Marissa E
authors.initials: ME
authors.lastname: Yingling
authors.affiliation: Department of Geography, University of Georgia, Athens, GA.
authors.forename: Jerry
authors.initials: J
authors.lastname: Shannon
mesh_terms: D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000628:therapy*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D062206:Spatial Analysis; D014481:United States
keywords: Medicaid; access; opioid treatment programs; opioid use disorder