Addiction care outcomes between insured and state opioid response grant-funded patients in a Medicaid non-expansion...

This study examines the impact of the State Opioid Response (SOR) grant on addiction care outcomes in uninsured patients at a longitudinal addiction and co-occurring disorder clinic (LACC).

In this retrospective cohort study, treatment engagement, substance use, and acute care utilization outcomes were compared between SOR grant-funded and traditionally insured patients receiving medications for opioid use disorder (MOUD).

Data from 607 patients were analyzed, with 472 in the traditional insurance group and 135 in the SOR grant-funded group. The SOR grant-funded group had more male patients (70.4% vs 48%) and higher rates of cannabis use disorder (19.3% vs 12.1%), stimulant use disorder (51.9% vs 26.3%), and HCV infection (3.7% vs 0.8%). Unadjusted data showed higher rates of MOUD adherence, opioid use, and stimulant co-use in SOR grant-funded patients. After adjusting for demographic, social, and clinical differences, care outcomes were similar between the two groups, although SOR grant-funded patients had longer general hospital admissions compared to traditionally insured patients.

The comparable adjusted outcomes between the two groups suggest that uninsured individuals can achieve similar treatment success when access to care is provided, and after accounting for demographic, social, and clinical differences. However, the longer length of stay in hospitalized SOR grant-funded patients highlights more complex health and social challenges that require additional support beyond what the SOR grant covers. These findings underscore the need to sustain and expand funding mechanisms like the SOR grant while broadening insurance coverage to address disparities in addiction care, particularly in Medicaid non-expansion states.