Expanding the eligibility criteria of West Virginians for Medicaid coverage in 2014 correlated with a growing number of enrollees being diagnosed and treated for opioid use disorder in one of the states most heavily impacted by the nationwide opioid crisis, a new study finds.
The study, published in the journal Health Affairs on Monday, analyzed Medicaid-reimbursed inpatient, outpatient and pharmacy claims for all people enrolled in the West Virginia Medicaid program under the Affordable Care Act between January 2014 and December 2016 to determine whether there were changes over time in opioid use disorder diagnosis and treatment.
The researchers found an increase in the number of people accessing treatment for opioid use disorder in the first three years of West Virginia's Medicaid expansion, especially among those using buprenorphine for treatment, where the ratio between the monthly percentage of people treated with buprenorphine to the monthly prevalence of those with an opioid use disorder diagnosis increased from "less than one-third in January 2014 to more than 75 percent in December 2016." Meanwhile, the annual diagnosed opioid use disorder prevalence in the sample was about 5.5 percent of all enrollees per year, according to the results.
"This is dramatically higher than previously reported rates for Medicaid enrollees with 2013 claims data, where the national average was 0.9 percent and the West Virginia average was about 1.7 percent," the study says.
But the diagnosis and uptake of treatment varied substantially by race, ethnicity, rural status and diagnosed comorbid health conditions like depression or hypertension. It also did not include the addition of methadone as a treatment option and broadened reimbursable services covered under West Virginia's Medicaid program in 2017, as that expansion was outside of the study's time frame.
