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Racial/Ethnic Disparities in Substance Use Treatment in Medicaid Managed Care in New York City

The Role of Plan and Geography

Bibliographic Data

ID9096470
AuthorsMargarita Alegria (0000-0003-2241-707X, Disparities Research Unit, Massachusetts General Hospital, corresponding author), Irene Falgas-Bague (0000-0002-1072-4243, Disparities Research Unit, Massachusetts General Hospital, corresponding author), Marie Fukuda (0000-0002-8843-2582, Disparities Research Unit, Massachusetts General Hospital, corresponding author), Jenny Zhen-Duan (Disparities Research Unit, Massachusetts General Hospital), Jenny Zhen‐Duan (0000-0002-5870-2617, Disparities Research Unit, Massachusetts General Hospital, corresponding author), Cole Weaver (Health Care Policy, Harvard Medical School, Boston, MA), Cole R Weaver (Harvard University), Isabel Shaheen O’Malley (0000-0002-5953-0976, Massachusetts General Hospital, corresponding author), Isabel O’Malley (Disparities Research Unit, Massachusetts General Hospital), Timothy Layton (0000-0001-9626-4892, Health Care Policy, Harvard Medical School, Boston, MA), Jacob Wallace (0000-0003-4533-5253, Yale School of Public Health, New Haven, CT), Lulu Zhang (0000-0003-2191-0663, Disparities Research Unit, Massachusetts General Hospital, corresponding author), Sheri Lapatin Markle (0000-0002-6768-3569, Massachusetts General Hospital, corresponding author), Sheri Markle (Disparities Research Unit, Massachusetts General Hospital), Pat Lincourt (New York State Office of Alcoholism and Substance Abuse Services, Albany), Shazia Hussain (0000-0001-5025-893X, New York State Office of Alcoholism and Substance Abuse Services, Albany), Roberto Lewis-Fernández (0000-0003-1305-7471, Department of Psychiatry, Columbia University, corresponding author), Dolly A John (New York State Psychiatric Institute, New York, NY, corresponding author), Thomas Mcguire (Health Care Policy, Harvard Medical School, Boston, MA)
Year2022
Volume60
Issue11
Pages806-812
Publication date2022-11-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001768
PMID36038524
OpenAlexW4293680422
LanguageEN
Citations received1
References cited26

OBJECTIVE: The aim was to assess the magnitude of health care disparities in treatment for substance use disorder (SUD) and the role of health plan membership and place of residence in observed disparities in Medicaid Managed Care (MMC) plans in New York City (NYC). DATA SOURCE: Medicaid claims and managed care plan enrollment files for 2015-2017 in NYC. RESEARCH DESIGN: We studied Medicaid enrollees with a SUD diagnosis during their first 6 months of enrollment in a managed care plan in 2015-2017. A series of linear regression models quantified service disparities across race/ethnicity for 5 outcome indicators: treatment engagement, receipt of psychosocial treatment, follow-up after withdrawal, rapid readmission, and treatment continuation. We assessed the degree to which plan membership and place of residence contributed to observed disparities. RESULTS: We found disparities in access to treatment but the magnitude of the disparities in most cases was small. Plan membership and geography of residence explained little of the observed disparities. One exception is geography of residence among Asian Americans, which appears to mediate disparities for 2 of our 5 outcome measures. CONCLUSIONS: Reallocating enrollees among MMC plans in NYC or evolving trends in group place of residence are unlikely to reduce disparities in treatment for SUD. System-wide reforms are needed to mitigate disparities

Business · Environmental health · Ethnic group · Family medicine · Health care · Health equity · Managed care · Medicaid · Political science · Psychiatry · Psychosocial · Public health · Receipt · Residence · Sociology · Demography · Medicine · Mental Health Treatment and Access · Nursing · Opioid Use Disorder Treatment · Substance Abuse Treatment and Outcomes · Gerontology

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Citations per year1
Citation span2025 - 2025 (1)
Highly citedNo

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