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Access to and Engagement in Substance Use Disorder Treatment Over Time
Junqing Liu1, Amy Storfer-Isser1, Tami L Mark1
1National Committee for Quality Assurance, Washington, D.C. (Liu, Storfer-Isser, Oberlander, Scholle); RTI International, Washington, D.C. (Mark); Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts (Horgan, Garnick).
Objective:
This study evaluated whether access to and engagement in substance use disorder treatment has improved from 2010 to 2016.
Methods:
Data submitted by commercial and Medicaid health plans, representing over 163 million beneficiaries from 2010 to 2016, were analyzed.
Results:
For commercial plans, identification increased (from 1.0% to 1.6%, p<0.001), the initiation rate declined (from 41.9% to 33.7%, p<0.001), and the engagement rate also declined (from 15.8% to 12.1%, p<0.001). The decline in the initiation and engagement rates could not be explained by the increasing identification rates. For Medicaid plans, the identification rate increased (from 3.3% to 6.7%, p<0.001), and the initiation and engagement rates were unchanged.
Conclusions:
Although an increasing proportion of health plan members are being identified with substance use disorders, the majority of these individuals are not engaging in treatment.
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