Opioid Treatment Programs' Medicaid Patient Retention Rates

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.
• 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.