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Medicaid’s Role in Addressing the Opioid Epidemic

Medicaid's Role in Addressing the Opioid Epidemic
Table 1: State Indicators of Medicaid’s Role in Addressing the Opioid Epidemic
State Opioid overdose death rate per 100,000
(2014)
Medicaid coverage of opioid use disorder treatments % of total buprenorphine spending financed by Medicaid
(2016)
% of adults age 19-64 with Medicaid
(2015)
Inpatient or detox (2015) Partial hospitalization (2015) Care coordination/ case management (2015) All 3 prescriptions (2013)
Expanded Medicaid/Republican Governor
Arizona 8.8 Yes No Yes Yes 15% 13%
Arkansas 6.3 No No Yes No 8% 21%
Illinois 9.4 Yes No No No 15% 15%
Indiana 7.3 Yes Yes Yes No 17% 14%
Iowa 5.3 Yes Yes Yes No 18% 13%
Kentucky 16.8 Yes No No No 44% 18%
Maryland 15.0 No Yes No Yes 39% 12%
Massachusetts 17.0 Yes No No Yes 49% 22%
Michigan 10.9 Yes No Yes Yes 13% 16%
Nevada 12.7 Yes Yes No Yes 12% 14%
New Hampshire 23.4 No Yes Yes Yes 18% 11%
New Jersey 8.2 Yes Yes No Yes 22% 14%
New Mexico 20.2 Yes Yes No Yes 30% 22%
North Dakota 4.5 Yes Yes No Yes 17% 7%
Ohio 19.1 No No Yes Yes 50% 17%
Vermont 11.0 Yes No No Yes 68% 16%
State Average 12.2 12/16 8/16 7/16 11/16 27% 15%
Expanded Medicaid/Democratic or Independent Governor
Alaska 10.6 Yes No Yes No 34% 12%
California 5.0 No No No Yes 16% 14%
Colorado 9.4 Yes No Yes Yes 25% 22%
Connecticut 15.2 Yes No Yes Yes 44% 14%
Delaware 13.9 Yes No No Yes 40% 16%
DC 9.4 Yes No Yes Yes 45% 22%
Hawaii 3.9 Yes No Yes Yes 25% 16%
Louisiana 5.7 Yes Yes Yes No 8% 12%
Minnesota 6.0 Yes No Yes Yes 32% 13%
Montana 5.4 Yes No Yes No 7% 11%
New York 8.6 Yes No No Yes 38% 20%
Oregon 8.3 Yes No Yes Yes 24% 22%
Pennsylvania 9.0 Yes No Yes No 29% 15%
Rhode Island 19.8 No Yes Yes Yes 50% 15%
Washington 9.2 Yes No Yes Yes 26% 18%
West Virginia 31.6 Yes Yes Yes No 45% 26%
State Average 10.7 14/16 3/16 13/16 11/16 31% 17%
Did Not Expand Medicaid/Republican Governor
Alabama 5.6 Yes No No Yes 6% 15%
Florida 7.2 No No No Yes 5% 12%
Georgia 7.0 Yes Yes No Yes 7% 11%
Idaho 5.0 Yes No Yes No 13% 11%
Kansas 6.0 Yes Yes Yes No 8% 7%
Maine 13.7 Yes No No Yes 38% 20%
Mississippi 3.9 Yes No No No 4% 14%
Missouri 12.0 Yes No Yes Yes 16% 8%
Nebraska 3.2 Yes No No No 10% 8%
Oklahoma 13.0 Yes No No No 7% 11%
South Carolina 10.7 Yes Yes No No 12% 12%
South Dakota 4.1 Yes No No No 11% 8%
Tennessee 13.4 Yes No No No 10% 13%
Texas 4.3 Yes No No Yes 6% 7%
Utah 16.8 No No No Yes 4% 8%
Wisconsin 11.1 Yes Yes No Yes 37% 14%
Wyoming 9.3 Yes Yes Yes No 19% 6%
State Average 8.6 15/17 5/17 4/17 8/17 13% 11%
Did Not Expand Medicaid/Democratic Governor
North Carolina 10.0 Yes Yes No Yes 21% 12%
Virginia 9.1 No No Yes Yes 13% 7%
State Average 9.6 1/2 1/2 1/2 2/2 17% 10%
NOTES: The three prescriptions for opioid use disorder are methadone, buprenorphine, and naltrexone.
References

Assistant Secretary for Planning and Evaluation, Continuing Progress on the Opioid Epidemic: The Role of the Affordable Care Act, (Washington, DC: Assistant Secretary for Planning and Evaluation, January 2017), https://aspe.hhs.gov/pdf-report/continuing-progress-opioid-epidemic-role-affordable-care-act

Audrey J. Weiss, et al., Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009-2014 (Rockville, MD: Agency for Healthcare Research and Quality, January 2017), https://www.hcup-us.ahrq.gov/reports/statbriefs/sb219-Opioid-Hospital-Stays-ED-Visits-by-State.pdf

Center for Behavioral Health Statistics and Quality, 2015 National Survey on Drug Use and Health: Detailed Tables (Rockville, MD: Substance Abuse and Mental Health Services Administration, September 2016), https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.pdf

Colleen M. Grogan, et al., “Survey Highlights Differences in Medicaid Coverage for Substance Use Treatment and Opioid Use Disorder Medications,” Health Affairs 35, no. 12 (Dec. 2016):2289-2296, http://content.healthaffairs.org/content/35/12/2289.full

IMS Institute for Healthcare Informatics, Use of Opioid Recovery Medications: Recent Evidence on State Level Buprenorphine Use and Payment Types, (Parsippany, NJ: IMS Institute for Healthcare Informatics, September 2016), https://www.imshealth.com/files/web/IMSH%20Institute/Reports/Healthcare%20Briefs/IIHI_Use_of_Opioid_Recovery_Medications.pdf

Kaiser Family Foundation, Opioid Overdose Death Rates and All Drug Overdose Death Rates per 100,000 Population (Age-Adjusted), (Washington, DC: Kaiser Family Foundation, 2016), http://kff.org/other/state-indicator/opioid-overdose-death-rates/?currentTimeframe=0

Medicaid and CHIP Payment and Access Commission, State Policies for Behavioral Health Services Covered Under the State Plan (Washington, DC: Medicaid and CHIP Payment and Access Commission, June 2016), https://www.macpac.gov/publication/behavioral-health-state-plan-services/

National Institute on Drug Abuse, Overdose Death Rates (Bethesda: MD: National Institute on Drug Abuse, January 2017), https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

Substance Abuse and Mental Health Services Administration, Medication-Assisted Treatment (Rockville, MD: Substance Abuse and Mental Health Services Administration, November 2016), https://www.samhsa.gov/medication-assisted-treatment

Vernon K. Smith et al., Implementing Coverage and Payment Initiatives: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2016 and 2017 (Washington, DC: Kaiser Family Foundation, October 2016), http://kff.org/report-section/implementing-coverage-and-payment-initiatives-benefits-and-pharmacy/

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