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Services Under Medicaid Struggle to Keep Up with Demand

November 21, 2019

More North Carolina Medicaid patients with an opioid use disorder (OUD) are receiving medication treatment, but growth in this number is still not keeping pace with the demand for services, suggests an analysis from researchers at Duke University and the University of North Carolina.

With the number of North Carolina Medicaid enrollees with a reported OUD diagnosis climbing from just over 27,000 in 2013-2014 to more than 45,000 in 2017-2018, a higher number of individuals with OUD are receiving medication treatments. But the treatment rate has actually declined slightly, the researchers reported in a blog published in Health Affairs.

In addition, “roughly half of [North Carolina] Medicaid enrollees who initiate buprenorphine therapy for OUD remain on therapy for at least six months, suggesting that even patients who get treatment face challenges staying on it,” said Marisa Elena Domino, PhD, principal investigator at the University of North Carolina's Cecil G. Sheps Center for Health Services Research. Still, the researchers pointed out that this percentage retained in buprenorphine treatment actually exceeds national norms.

The researchers also pointed out that rates of outpatient treatment for OUD are even lower among North Carolina's uninsured than they are in the state's Medicaid population. “To be sure, Medicaid is an important mediical safety net that is also crucial in the ongoing fight against the opioid epidemic throughout North Carolina,” said Aaron McKethan, PhD, adjunct professor of population health sciences at the Duke University School of Medicine.

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