The Virginia Division of Medical Help Providers final week launched a report, led by a workforce of researchers at Virginia Commonwealth University, highlighting a major enhance in entry to dependancy and restoration remedy providers because of Medicaid enlargement.
Greater than 46,500 Medicaid members obtained care by means of the Habit and Restoration Therapy Providers profit in 2019, the primary yr eligibility for well being protection expanded to extra low-income adults, together with childless adults who had been excluded below earlier insurance policies. Participation in ARTS elevated 79% between 2018 and 2019.
Virginia launched the ARTS profit in April 2017 to extend entry to take care of Medicaid members with substance use issues and enhance the standard of providers accessible. Researchers within the Department of Health Behavior and Policy on the VCU School of Medicine have been conducting the unbiased, multiyear analysis of the ARTS profit.
“The findings present Virginia has made substantial and fast progress over the previous 5 years in increasing entry to dependancy remedy providers by means of the Medicaid program — first by increasing remedy providers by means of the ARTS program in 2017 after which by drastically increasing eligibility for these providers by means of Medicaid enlargement in 2019,” stated Peter Cunningham, Ph.D., a professor within the Division of Well being Habits and Coverage who’s main the analysis with affiliate professor Andrew Barnes, Ph.D. “This has put the state in a a lot stronger place to deal with the surge in substance use issues that we’re seeing in Virginia and throughout the nation as a result of COVID-19 pandemic.”
Researchers discovered that progress within the Habit and Restoration Therapy Providers profit was pushed not solely by newly eligible adults but in addition by means of elevated participation by Medicaid members who have been already eligible for well being protection earlier than the enlargement. Therapy charges for dependancy among the many latter group grew from 19.9% in 2016, earlier than the ARTS program started, to 47.4% in 2019. Therapy charges particularly for opioid use dysfunction amongst this group elevated from 32.1% in 2016 to 65.9% in 2019.
“These findings display our capability to answer the urgent want for dependancy and restoration remedy at a time when the Medicaid program was experiencing historic progress,” stated Ellen Montz, Ph.D., chief deputy and chief well being economist with the Division of Medical Help Providers. “Even so, we all know there may be extra work to do to make sure that everybody searching for restoration has entry to high-quality, evidence-based remedy. This analysis gives the info we have to obtain that purpose.”
Almost 4,900 outpatient practitioners offered care by means of the ARTS profit in 2019, a 31% enhance from 2018 and quadruple the quantity billing Medicaid for dependancy providers in 2016. The report discovered that Virginia suppliers have considerably elevated using remedy to deal with opioid use dysfunction, bringing the commonwealth extra in keeping with practices in peer states. Nonetheless, researchers additionally famous a scarcity of suppliers with federal authorization to prescribe buprenorphine, a drugs for treating opioid use dysfunction.
In evaluating the standard of care accessible to Virginia Medicaid members, researchers discovered that, in 2019, 87% of Medicaid members with opioid use dysfunction obtained remedy inside 30 days of discharge from a residential remedy facility and 53.5% obtained remedy inside 30 days of an emergency division go to associated to opioid use dysfunction.
Researchers additionally documented a 26% lower in emergency division visits associated to opioid use dysfunction between 2016 and 2018. In distinction, all different emergency division visits elevated by 5% throughout that interval.
In 2019, emergency division visits elevated amongst Medicaid members for substance use issues total and opioid use dysfunction particularly. The report famous that there have been 1,626 deadly drug overdoses in Virginia that yr, a 9.4% enhance in comparison with 2018, reflecting a nationwide surge in overdose deaths.
Researchers examined continued racial disparities in remedy charges, with 56% of white Medicaid members and 40% of Black members receiving substance use dysfunction providers. The report documented information indicating that Black Medicaid members are much less more likely to obtain follow-up providers and to proceed remedy. Researchers famous that Black members reported having a much less favorable expertise with remedy in comparison with white members. Black members additionally reported that they felt much less capable of make their very own decisions about remedy choices.
“This report paperwork super accomplishments because the launch of the ARTS profit,” stated Tammy Whitlock, deputy of complicated care and providers on the Division of Medical Help Providers, “and it additionally provides a rigorous evaluation of needed subsequent steps to construct belief and enhance communication with our members in our continued effort to the touch lives and scale back the unimaginable struggling in our households and communities.”
Along with Cunningham and Barnes, authors of the report from the VCU Faculty of Medication’s Division of Well being Habits and Coverage embody Megan Mueller, Erin Britton, Huyen Pham, Lauren Guerra, Heather Saunders, Xue Zhao and Vimbainashe Dihwa.
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