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Physicians as Mediators of Health Policy: Acceptance of Medicaid in the Context of Buprenorphine Treatment

  • Hannah K. Knudsen
  • Jamie L. Studts
Article

Abstract

Increasing numbers of individuals with opioid use disorder (OUD) are insured by Medicaid. Little is known about whether providers of buprenorphine, an evidence-based OUD pharmacotherapy, accept this type of payment. Data are scant regarding whether Medicaid acceptance varies by physician and state-level characteristics. To address these gaps, national survey data from 1174 buprenorphine-prescribing physicians (BPPs) and state characteristics were examined in a multi-level model of Medicaid acceptance. Only 52.0% of BPPs accepted Medicaid for buprenorphine-related office visits. Specialists in addiction and psychiatry were significantly less likely to accept Medicaid than other specialties, as were BPPs delivering buprenorphine in individual medical practice. Perceived adequacy of Medicaid reimbursement was positively associated with accepting Medicaid. Medicaid acceptance was not associated with states’ implementation of the Medicaid expansion. Individuals who are covered by Medicaid may face barriers to accessing buprenorphine treatment, which has high public health significance given the ongoing opioid epidemic.

Notes

Acknowledgements

This study was supported by funding from the National Institute on Drug Abuse (NIDA Grant R33DA035641), an institute within the National Institutes of Health (NIH). The use of REDCap was supported by a grant from the National Center for Advancing Translational Sciences (NIH CTSA UL1TR000117). The content of this manuscript is solely the responsibility of the authors and does not represent the official views of the NIH or NIDA. The authors gratefully acknowledge the physicians who participated in the study and the efforts of the research staff: Jennifer Cook, Eric Shelton, Diana Norkus, Danielle Rosenkrantz, Jorge Masson, Joseph Calvert, and Haley Clark.

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflicts of interest.

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Copyright information

© National Council for Behavioral Health 2018

Authors and Affiliations

  1. 1.Department of Behavioral Science and Center on Drug and Alcohol ResearchUniversity of KentuckyLexingtonUSA
  2. 2.Department of Behavioral ScienceUniversity of KentuckyLexingtonUSA

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