Table 2.

Claims-based measures and definitions for study outcomes

Measure	Operational definition
Supply measures
Percent of physicians certified to prescribe buprenorphine	Number of physicians on SAMHSA list of buprenorphine or naltrexone prescribers/# Medicaid-participating physicians in county
Percent of primary care practices delivering MAT	Number of physicians with any prescribing of buprenorphine or naltrexone/# Medicaid-participating physicians in county measured in claims data
Prevalence measures
OUD diagnoses	OUD ICD-9/ICD-10 code on inpatient, outpatient or professional claims
Overdose events	Inpatient stays or ED visits with an opioid overdose ICD-9/ICD-10 code
OUD diagnoses among those with evidence of misuse of prescription opioids	Rate of OUD diagnosis among those with opioid misuse using an algorithm from Sullivan et al. [46] that uses # prescribers, # pharmacies, and # days short- and long-acting opioids
Utilization measures
Use of MAT	Any prescription fill for buprenorphine or IM naltrexone among those with OUD
Use of psychosocial supports	Any visit with a service code for psychosocial support for OUD
Access to counseling for OUD	Any visit with a service code for counseling regarding psychosocial and pharmacologic treatment options among those with OUD
Duration of MAT	Number of months with proportion of days covered > 80%
Access to tele-psychiatry	Any visit with a service code for a tele-psychiatry visit
Outcome measures
Likelihood of any and SUD or mental health-related emergency department visit	SUD or mental health ICD-9/ICD-10 code as primary diagnosis for an emergency department visit
Likelihood of any and SUD or mental health-related inpatient hospitalization	SUD or mental health ICD-9/ICD-10 code as primary diagnosis for an inpatient hospitalization

SAMHSA Substance Abuse and Mental Health Services Administration, MAT medication assisted treatment, OUD opioid use disorder, ICD international classification of diseases, SUD substance use disorder