Medicaid Coverage of Methadone Maintenance and the Use of Opioid Agonist Therapy Among Pregnant Women in Specialty Treatment

Bibliographic Data

ID9099515
AuthorsMarcus A Bachhuber (0000-0002-5610-8382, Department of Medicine, Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, corresponding author), Pooja Mehta (0000-0002-2367-6762, Boston University), Pooja K Mehta (0000-0002-9281-3599, Department of Obstetrics and Gynecology, Boston University School of Medicine), Laura J Faherty (0000-0002-8953-8856, RAND Corporation, Boston, MA), Brendan Saloner (0000-0001-9013-3023, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD)
Year2017
Volume55
Issue12
Pages985-990
Publication date2017-12-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000803
PMID29135769
OpenAlexW2767578029
LanguageEN
Citations received4
References cited34

BACKGROUND: Opioid agonist therapy (OAT) is the standard of care for pregnant women with opioid use disorder (OUD). Medicaid coverage policies may strongly influence OAT use in this group. OBJECTIVE: To examine the association between Medicaid coverage of methadone maintenance and planned use of OAT in the publicly funded treatment system. RESEARCH DESIGN: Retrospective cross-sectional analysis of treatment admissions in 30 states extracted from the Treatment Episode Data Set (2013 and 2014). SUBJECTS: Medicaid-insured pregnant women with OUD (n=3354 treatment admissions). MEASURES: The main outcome measure was planned use of OAT on admission. The main exposure was state Medicaid coverage of methadone maintenance. Using multivariable logistic regression models adjusting for sociodemographic, substance use, and treatment characteristics, we compared the probability of planned OAT use in states with Medicaid coverage of methadone maintenance versus states without coverage. RESULTS: A total of 71% of pregnant women admitted to OUD treatment were 18-29 years old, 85% were white non-Hispanic, and 56% used heroin. Overall, 74% of admissions occurred in the 18 states with Medicaid coverage of methadone maintenance and 53% of admissions involved planned use of OAT. Compared with states without Medicaid coverage of methadone maintenance, admissions in states with coverage were significantly more likely to involve planned OAT use (adjusted difference: 32.9 percentage points, 95% confidence interval, 19.2-46.7). CONCLUSIONS: Including methadone maintenance in the Medicaid benefit is essential to increasing OAT among pregnant women with OUD and should be considered a key policy strategy to enhance outcomes for mothers and newborns

Buprenorphine · Family medicine · Health care · Logistic regression · Medicaid · Medical prescription · Methadone · Methadone maintenance · Opiate Substitution Treatment · Opioid · Opioid use disorder · Pregnancy · Psychiatry · Retrospective cohort study · Specialty · Demography · Emergency Medicine · Internal Medicine · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Nursing · Opioid Use Disorder Treatment · Prenatal Substance Exposure Effects

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