A team led by Scientist Maureen Stewart, PhD’09, has received a four-year, $2.7 million grant from the National Institute on Drug Abuse (NIDA). The research team, from Heller’s Institute for Behavioral Health, will study opioid addiction treatment offered through Medicaid Health Plans.
State Medicaid programs provide health care coverage to low-income people and those with disabilities, but most states contract with private health plans to administer or manage Medicaid benefits. These Medicaid Health Plans—the focus of Stewart’s study—have broad discretion about what they cover and how they manage services. Eighty-four percent of Medicaid enrollees are covered by a Medicaid Health Plan.
People with opioid use disorder (OUD) are more likely to have Medicaid coverage. Although Medicaid Health Plans are subject to state guidelines, they have leeway to create their own provider networks and establish their own payment policies. Until now, no one has tried to examine how this variation is affecting Medicaid patients’ access to quality addiction services.
“Over 50,000 people died of opioid overdoses in 2019. We have three effective medications to treat OUD, but most people do not get them,” says Stewart.
“Medicaid Health Plans are all required by law to offer addiction treatment, but there’s a big difference between covering addiction treatment and making it easy to access quality addiction treatment. Their policies can be more or less flexible, plans can choose to implement innovative policies to try to help individuals with OUD,” she adds.
This study will identify which plans seem to have better outcomes and examine the policies they have in place, and vice versa. Stewart hopes that state Medicaid directors and Medicaid Health Plans could leverage her future findings to implement policies that are associated with better outcomes for OUD patients.
The focus of Stewart’s research is increasingly relevant today, as Medicaid enrollment is growing quickly due to pandemic-related job losses. In Massachusetts alone, almost 20,000 people were added to Medicaid in the month of June. Across the country, approximately 17 million people could be newly eligible for Medicaid this year due to job loss.
Joining Stewart on this project are IBH Director Constance Horgan, Associate Dean for Research Cindy Parks Thomas, PhD’00, Professor Dominic Hodgkin, and Associate Professor Grant Ritter, who are also affiliated researchers at the Opioid Policy Research Collaborative at IBH.
This study builds on Horgan’s 20-year-long private health plan survey project, a series of four separate surveys of delivery and management of mental health and substance use disorder treatment in private health plans. That research demonstrated wide variation among private health plans, so Stewart and her team are eager to see whether the same will be true of opioid addiction treatment in Medicaid Health Plans.
“This study is critical to understanding how Medicaid coverage can facilitate access to quality opioid addiction treatments, especially medication treatments,” says Horgan. “This becomes ever more important as the opioid epidemic persists and as Medicaid enrollment grows during this economic crisis. I am immensely proud that our team can contribute to such impactful research.”