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

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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.

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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.

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  1. Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 204, Lexington, KY, 40508, USA

    Hannah K. Knudsen PhD

  2. Department of Behavioral Science, University of Kentucky, 127 Medical Behavioral Science Building, Lexington, KY, 40536-0086, USA

    Jamie L. Studts PhD

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Correspondence to Hannah K. Knudsen PhD.

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Knudsen, H.K., Studts, J.L. Physicians as Mediators of Health Policy: Acceptance of Medicaid in the Context of Buprenorphine Treatment. J Behav Health Serv Res 46, 151–163 (2019). https://doi.org/10.1007/s11414-018-9629-4

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