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Urban Institute: Medicaid MAT Coverage Varies by State

While Medicaid coverage for medication-assisted treatment (MAT) prescriptions for individuals with opioid use disorder (OUD) increased substantially between 2011 and 2018, prescribing rates varied greatly among states, according to an Urban Institute study.

On average, states that expanded Medicaid under the Affordable Care Act (ACA) saw higher MAT prescribing rates than nonexpansion states. In 2018, expansion states saw an average of 138 buprenorphine prescriptions per 1,000 Medicaid beneficiaries, compared to 41 per 1,000 Medicaid beneficiaries in nonexpansion states.

The study found stark differences between states with the highest and lowest MAT prescribing rates. The prescribing rate in Vermont — which had the highest 2018 rate, at 1,210 prescriptions per 1,000 beneficiaries — was 200 times greater than that of the state with the lowest rate, Arkansas, at five prescriptions per 1,000 beneficiaries.

Researchers assume that some state-level differences in prescribing rates might reflect differences in underlying rates of OUD and prescription-writing practices, but other factors, including Medicaid expansion and lack of treatment capacity and effectiveness, likely contribute to the variation.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Rachel Schwartz is a policy associate at America's Essential Hospitals.

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