Disparities in access to medications for opioid use disorder (MOUD) are stark – While the overdose rates for blacks and Hispanics have risen nearly twice as fast as compared to whites, blacks and Hispanics are 3x’s less likely to receive MOUD and other overdose prevention services. Such inequities are rooted in the structural racism ingrained in policies governing healthcare, housing, social services, criminal justice, and other systems. As the largest single payer for MOUD and a key source of coverage for racial and ethnic minority groups, Medicaid is well-positioned to address inequities in MOUD access. Specifically, state Medicaid agencies can adopt policies to alter both financial incentives for MOUD providers and contracts with managed care plans to improve equity in MOUD.
With support from the National Institute on Drug Abuse (NIDA), the Medicaid Outcomes Distributed Research Network (MODRN) will inform Medicaid policy development by examining the role of place, providers, plans, and policies in driving racial and ethnic inequities in MOUD access, building upon existing work studying the quality of opioid use disorder treatment in Medicaid. This MODRN project is made up of university partnerships with Medicaid agencies in 11 states representing 22 percent of all U.S. Medicaid enrollees that vary in Medicaid policy. This research will use geospatial analyses, multi-level modeling, and difference-in-difference analyses to accomplish these specific aims.