Poster #69 - Medicaid Managed Care Coverage and Receipt of Medication for Alcohol Use Disorder

• In Event: Friday Poster Reception

Abstract

Alcohol use disorder (AUD) afflicts one in ten Americans. As one of the largest payers of AUD treatment in the United States, Medicaid managed care plays a key role in facilitating access to AUD treatment services and medications. However, little is known about how AUD coverage in Medicaid managed care organizations (MCOs) affects treatment receipt. We conducted the first ever examination of the relationship between the comprehensiveness of Medicaid MCO plan coverage and receipt of medications for AUD (MAUD). To leverage the methodological advantages of randomization, we used Medicaid data from Kentucky, a state in which Medicaid enrollees are auto-assigned to one of five MCO plans. The final analytic sample consisted of 202,230 newly enrolled Medicaid beneficiaries. Kentucky’s quasi-random assignment of beneficiaries to MCO plans allowed use of a two stage least squares/instrumental variable (TSLS/IV) modeling approach to achieve unbiased estimates of the effects of MCO coverage on receipt of MAUD. Results indicate that the percentage of beneficiaries who received MAUD was very low—just 0.5%. Regression results indicated that for each additional treatment modality covered, the probability of receiving MAUD increased by 6.7% over baseline [baseline: 0.5%; difference per additional service/MAUD (in percentage points): 0.033; p<0.05]. Further, increasing MCO plan coverage of the least comprehensive plan to match the most comprehensive plan would increase the probability of receiving MAUD by 47%. Study findings indicate that when insurance plans cover a broader array of AUD treatment services and medications, patients are more likely to receive MAUD.

Author

• Miguel Antonio Garcia Estrada, University of Georgia
  Presenting Author