Institute for Behavioral Health

Medicaid Managed Care Opioid and Alcohol Treatment Policy Study (MOATS)

The Medicaid Managed Care Opioid and Alcohol Treatment Policy Study (MOATS) examines the relationships between Medicaid managed care organization policies and access to and quality of substance use disorder (SUD) treatment services with the goal of identifying strategies to improve substance use treatment.

The United States continues to struggle with a major crisis of opioid addiction. More than 93,000 people deaths were attributed to opioid use in 2020. Rates of opioid use disorders (OUDs) in the Medicaid population are almost twice as high as the general population, thus ensuring access to quality OUD treatment is a necessity for Medicaid enrollees.

In addition, unhealthy alcohol use is common in the United States; 66 million Americans reported binge drinking in the last month and 14.6 million have an alcohol use disorder. Early data show alcohol use increased with COVID-19. Rates of alcohol-related health conditions are disproportionately high and increasing among racial/ethnic minorities and women. Almost 90,000 Americans die annually from alcohol use.  Further, alcohol-related deaths have been increasing at a faster rate for racial/ethnic minorities, women and in rural areas.

Almost all state Medicaid programs contract with Medicaid managed care organizations to deliver and manage health care services Medicaid managed care organizations serve over 54 million Americans -nearly 70% of Medicaid enrollees. Managed care organizations must adhere to state Medicaid requirements, but also have flexibility to implement their own policy decisions. Despite the reach of Medicaid managed care, there is limited information about policies that may affect SUD treatment access and quality. Building on the success of four previous commercial health plan surveys, this project will provide a current picture of SUD treatment services in Medicaid managed care plans.

Findings will provide valuable information regarding access to and effectiveness of SUD treatment in Medicaid managed care organizations. This information can be used by plan administrators as they develop and implement plan policies, state Medicaid directors as they contract with and regulate Medicaid managed care organizations and federal policy makers making determinations about use of Medicaid waivers and other efforts to address opioid and alcohol use disorders in the US, to help stem the tide of SUD its often-deadly consequences.


The Medicaid Managed Care Opioid and Alcohol Treatment Policy Study (MOATS) is funded by The National Institute on Drug Abuse (NIDA; Grant: R01DA049776) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA; Grant: R01AA029821). NIDA and NIAAA are Institutes within the National Institutes of Health. The contents of this website do not represent the policy of NIDA, NIAAA, or NIH, and do not signify endorsement by the United States Federal Government.