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Comparative Study
. 2019 Jan;46(1):151-163.
doi: 10.1007/s11414-018-9629-4.

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

Hannah K Knudsen  1 , Jamie L Studts  2
Affiliations
Comparative Study

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

Hannah K Knudsen et al. J Behav Health Serv Res. 2019 Jan.

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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Conflict of interest statement

Conflicts of Interest

The authors have no conflicts of interest to report.

Figures

Figure 1
Figure 1
Conceptual model of Medicaid acceptance by buprenorphine-prescribing physicians (BPPs)
See this image and copyright information in PMC

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