Treatment for Alcohol Use Disorder in Medicaid Managed Care

医疗补助管理护理中酒精使用障碍的治疗

基本信息

批准号：
10615794
负责人：
Amanda J Abraham
金额：
$ 63.66万
依托单位：
UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-10 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10615794
关键词：
AODR mortality Accounting Address Adherence Affect Age Alcohols American Behavior Therapy Caring Centers for Disease Control and Prevention (U.S.)Cessation of life Clinical Contracts Data Data Set Diagnosis Emergency department visit Ensure Health Health Services Accessibility Heavy Drinking Hospitalization Improve Access Investigation Kentucky Link Managed Care Medicaid Methods Morality Ohio Outcome Patients Pharmaceutical Preparations Policies Policy Maker Population Positioning Attribute Public Health Randomized Recommendation Relapse Research Selection Bias Series Structure Substance Use Disorder Time United States Vulnerable Populations access restrictions acute care adverse outcome alcohol abuse therapy alcohol availability alcohol use disorder craving design evidence base health knowledge indexing innovation knowledge base longitudinal analysis mortality prior authorization programs public health priorities treatment services

AODR mortality Accounting Address Adherence Affect Age Alcohols American Behavior Therapy Caring Centers for Disease Control and Prevention (U.S.)Cessation of life Clinical Contracts Data Data Set Diagnosis Emergency department visit Ensure Health Health Services Accessibility Heavy Drinking Hospitalization Improve Access Investigation Kentucky Link Managed Care Medicaid Methods Morality Ohio Outcome Patients Pharmaceutical Preparations Policies Policy Maker Population Positioning Attribute Public Health Randomized Recommendation Relapse Research Selection Bias Series Structure Substance Use Disorder Time United States Vulnerable Populations access restrictions acute care adverse outcome alcohol abuse therapy alcohol availability alcohol use disorder craving design evidence base health knowledge indexing innovation knowledge base longitudinal analysis mortality prior authorization programs public health priorities treatment services

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项目摘要

PROJECT SUMMARY As the nation continues to grapple with rising alcohol-related hospitalization and mortality, expanding access to alcohol use disorder (AUD) treatment remains an urgent public health priority. While Medicaid is positioned to be a key policy lever to improve access to AUD treatment and reduce mortality among vulnerable populations, many state Medicaid programs do not cover the full continuum of AUD treatment and use utilization management parameters that may restrict access. Moreover, most state Medicaid programs contract with managed care organizations (MCOs). While over 70% of all Medicaid enrollees participate in MCO plans, little is known about how these plans cover AUD treatment. To fill this gap in the scientific evidence, we will conduct the first multi-state study of the effects of Medicaid MCO coverage and utilization management design on AUD treatment receipt and outcomes. The study will encompass 142 MCO plans, across 18 states, for the full continuum of treatment. We also propose to make use of innovative random auto-assignment methods in two state Medicaid programs. Our specific aims will include: (1) estimating how MCO plans’ coverage and utilization management designs are associated with progression through the major stages of identification and treatment of AUD (diagnosis, initiation, engagement, and retention); (2) estimating how MCO plans’ coverage and utilization management parameters are associated with alcohol-related emergency department visits and hospitalizations; and (3) estimating how progression through the stages of identification and treatment of AUD is associated with alcohol-related mortality. The proposed study will be the first comprehensive investigation of the effects of MCO coverage for AUD treatment on treatment receipt and outcomes – evidence without which the care of a large fraction of the AUD population is compromised. As alcohol-related hospitalization and mortality continue to rise, evidence regarding the impact of Medicaid MCO coverage for AUD treatment is urgently needed. This research will equip policymakers with evidence-based guidance on how to structure MCO contractual arrangements to ensure appropriate and efficient access to AUD treatment. 1

项目摘要随着国家继续努力应对与酒精有关的住院和死亡率的增加，扩大了进入的机会酒精使用障碍（AUD）治疗仍然是紧急的公共卫生优先事项。医疗补助定位为成为提高获得AUD治疗并降低脆弱人群死亡率的关键政策杠杆，许多州医疗补助计划并不涵盖AUD治疗的全部持续和使用可能限制访问的管理参数。此外，大多数州医疗补助计划与托管护理组织（MCO）。虽然超过70％的医疗补助招募参加MCO计划，但很少这些计划如何涵盖AUD处理。为了填补科学证据，我们将进行医疗补助MCO覆盖范围和利用管理设计对AUD的影响的首次多国家研究治疗收据和结果。该研究将涵盖18个州的142个MCO计划连续治疗。我们还建议在两种中使用创新的随机自动分配方法州医疗补助计划。我们的具体目的包括：（1）估计MCO计划的覆盖范围和利用管理设计与通过识别的主要阶段的进步有关， AUD的处理（诊断，主动性，参与和保留）；（2）估计MCO计划的覆盖范围和利用管理参数与酒精相关的急诊室就诊和住院；（3）估计如何通过AUD的识别和处理阶段进展与酒精相关的死亡率有关。拟议的研究将是对 MCO覆盖范围对于AUD治疗对治疗收据和结果的影响 - 没有证据大部分AUD人群的照顾受到损害。作为与酒精有关的住院和死亡率继续上升，有关医疗补助MCO覆盖范围对AUD治疗的影响的证据是迫切需要。这项研究将使政策制定者获得有关如何构建的循证指导 MCO合同安排，以确保适当有效地获得AUD治疗。 1

项目成果

期刊论文数量（2）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Coverage and Prior Authorization Policies for Medications for Opioid Use Disorder in Medicaid Managed Care.

DOI：
10.1001/jamahealthforum.2022.4001
发表时间：
2022-11-04
期刊：
JAMA HEALTH FORUM
影响因子：
0
作者：
Abraham, Amanda J;Andrews, Christina M;Harris, Samantha J;Westlake, Melissa M;Grogan, Colleen M
通讯作者：
Grogan, Colleen M

Changes in Medicaid Fee-for-Service Benefit Design for Substance Use Disorder Treatment During the Opioid Crisis, 2014 to 2021.