Johns Hopkins University, Baltimore, MD, USA.
University of Pittsburgh, PA, USA.
Med Care Res Rev. 2023 Aug;80(4):423-432. doi: 10.1177/10775587231167514. Epub 2023 Apr 21.
Provider networks in Medicaid Managed Care (MMC) play a crucial role in ensuring access to buprenorphine, a highly effective treatment for opioid use disorder. Using a difference-in-differences approach that compares network breadth across provider specialties and market segments within the same state, we investigated the association between three Medicaid policies and the breadth of MMC networks for buprenorphine prescribers: Medicaid expansion, substance use disorder (SUD) network adequacy criteria, and SUD carveouts. We found that both Medicaid expansion and SUD network adequacy criteria were associated with substantially increased breadth in buprenorphine-prescriber networks in MMC. In both cases, we found that the associations were largely driven by increases in the network breadth of primary care physician prescribers. Our findings suggest that Medicaid expansion and SUD network adequacy criteria may be effective strategies at states' disposal to improve access to buprenorphine.
医疗补助管理式医疗（MMC）中的供应商网络在确保阿片类药物使用障碍的高度有效治疗药物丁丙诺啡的可及性方面发挥着关键作用。我们采用差异中的差异方法，比较了同一州内的供应商专业和市场细分之间的网络广度，研究了三种医疗补助政策与丁丙诺啡处方者 MMC 网络广度之间的关联：医疗补助扩大、物质使用障碍（SUD）网络充足标准和 SUD 除外。我们发现，医疗补助扩大和 SUD 网络充足标准都与 MMC 中丁丙诺啡处方者网络的广度显著增加有关。在这两种情况下，我们发现关联主要是由初级保健医生处方者网络广度的增加驱动的。我们的研究结果表明，医疗补助扩大和 SUD 网络充足标准可能是各州可用来改善丁丙诺啡可及性的有效策略。
