Insurance Coverage and Provision of Opioid Disorder Treatment: Evidence From Medicare

• 成果类型: Article
• 署名作者: Agniel, Denis; Cantor, Jonathan; Maclean, Johanna Catherine; Taylor, Erin A.; Simon, Kosali
• 署名单位: RAND Corporation; Rand Health; George Mason University; National Bureau of Economic Research; Indiana University System; Indiana University Bloomington; National Bureau of Economic Research
• 刊物名称: JOURNAL OF POLICY ANALYSIS AND MANAGEMENT
• ISSN/ISSBN: 1520-6688
• DOI: 10.1002/pam.70106
• 发表日期: 2026-05-05
• 页码: e70106
• 关键词: insurance; medicare; opioids; spillovers; Substance-abuse treatment; health-insurance; ECONOMIC EVALUATIONS; older-adults; care; buprenorphine; maintenance; procurement; expansion; BEHAVIOR

摘要

Older adult opioid overdose deaths have increased over the past two decades in the United States. Methadone, one of three medications approved for opioid use disorder (OUD) treatment, was not covered by Medicare-the primary insurer of Americans 65 years and older-for OUD until 2020. We study the response of opioid treatment programs (OTPs), the only healthcare providers that can dispense methadone for the treatment of OUD in the United States, to this policy change using administrative data and a difference-in-differences framework. We find an increase in Medicare acceptance by OTPs and in the number of methadone treatment episodes post-policy. Further, we document spillovers to other insurance markets and changes in (non-methadone) treatment services offered by OTPs, suggesting that Medicare's entrance into this market has implications for all OUD patients receiving methadone treatment in OTPs.