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Opioid Treatment Programs' Medicaid Patient Retention Rates.

Dylan E DeLisle1, Tami L Mark1, Chelsea Katz1

  • 1RTI International, Durham, North Carolina.

JAMA Network Open
|January 23, 2026
PubMed
Summary
This summary is machine-generated.

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Retention in opioid treatment programs (OTPs) using methadone or buprenorphine is crucial for reducing overdose deaths. This study found low patient retention rates across OTPs, highlighting opportunities for improving treatment engagement and patient outcomes.

Area of Science:

  • Addiction Medicine
  • Health Services Research
  • Public Health

Background:

  • Retention in medication treatment for opioid use disorder (OUD) is linked to reduced mortality.
  • Opioid Treatment Programs (OTPs) are vital for dispensing methadone and increasingly buprenorphine for OUD.
  • Comparing patient retention rates can identify underperforming OTPs and motivate quality improvement.

Purpose of the Study:

  • To develop a standardized, case mix-adjusted metric for assessing Medicaid patient retention in OTPs.
  • To provide a benchmark for evaluating OTP performance in retaining patients in OUD treatment.
  • To identify variations in retention rates across OTPs to guide quality improvement initiatives.

Main Methods:

  • A cohort study utilizing Medicaid outpatient claims and demographic data from 2018-2023.

Related Experiment Videos

  • Inclusion of all US OTPs with at least 11 eligible adult Medicaid beneficiaries diagnosed with OUD.
  • Calculation of 30, 90, and 180-day retention rates, adjusted for patient characteristics.

    • Main Results:

    • The study analyzed data from 261,025 Medicaid beneficiaries across 1138 OTPs.
    • Median 30-day retention was 61.2%, 90-day was 41.5%, and 180-day was 27.5% in 2023.
    • Significant variability in retention rates was observed among OTPs.

    Conclusions:

    • This study identified low and variable patient retention rates in OTPs for Medicaid beneficiaries.
    • The findings suggest substantial opportunities for enhancing patient engagement and treatment duration.
    • Developing standardized retention measures is essential for quality improvement in OUD treatment.