Exhibit 4.
State characteristic | Facilities offering MT | Odds ratios, comparison of facilities offering and not offering MT | ||
---|---|---|---|---|
Numbera | Percent | Unadjusted | Adjustedb | |
12-month prevalence of heroin use, 2015–16c | ||||
Low (<0.37%; n = 5,666) | 1,790 | 31.6 | 1.00 | 1.00 |
High (≥0.37%; n = 6,027) | 2,428 | 40.3 | 1.46**** | 1.67*** |
Opioid overdose death rate per 100,000 in 2015–16d | ||||
Low (<13.1; n = 5,729) | 1,716 | 30.0 | 1.00 | 1.00 |
High (≥13.1; n = 5,964) | 2,502 | 42.0 | 1.69**** | 2.25**** |
Expanded eligibility for Medicaid (all facilities) | ||||
No (n = 4,118) | 1,371 | 33.3 | 1.00 | 1.00 |
Yes (n = 7,575) | 2,847 | 37.6 | 1.21**** | 1.31 |
Expanded eligibility for Medicaid (facilities accepting Medicaid) | ||||
No (n = 2,608) | 713 | 27.3 | 1.00 | 1.00 |
Yes (n = 5,053) | 2,165 | 42.8 | 1.89*** | 1.81*** |
Number of MT medications covered by state’s Medicaid programe (all facilities) | ||||
One (n = 703) | 174 | 24.8 | 1.00 | 1.00 |
Two (n = 1,818) | 559 | 30.7 | 1.35*** | 1.68 |
All three (n = 9,172) | 3,485 | 38.0 | 1.86**** | 2.32* |
Test of trendf | —g | —g | 1.44** | 1.44** |
Number of MT medications covered by state’s Medicaid programe (facilities accepting Medicaid) | ||||
One (n = 342) | 102 | 29.8 | 1.00 | 1.00 |
Two (n = 1,232) | 323 | 26.2 | 1.34 | 1.31 |
All three (n = 6,087) | 2,453 | 40.3 | 2.11 | 2.16 |
Test of trendf | —g | —g | 1.52** | 1.57** |
All ASAM levels of care covered under state’s Medicaid program (all facilities)?h | ||||
No (n = 4,587) | 1,543 | 33.6 | 1.00 | 1.00 |
Yes (n = 7,106) | 2,675 | 37.6 | 1.19 | 1.22 |
All ASAM levels of care covered under state’s Medicaid program (facilities accepting Medicaid)?h | ||||
No (n = 2,950) | 958 | 32.5 | 1.00 | 1.00 |
Yes (n = 4,711) | 1,920 | 40.8 | 1.33 | 1.33 |
source Authors’ analysis of data for 2016 from the National Survey of Substance Abuse Treatment Services and other sources listed below.
notes Facilities that treated only patients convicted of driving while intoxicated or driving under the influence were excluded. Of the 11,693 facilities in the study, 4,218 (36.1 percent) offered MT (defined as offering methadone, buprenorphine, or extended-release naltrexone). ASAM is American Society of Addiction Medicine.
Actual number of facilities, not imputed data.
Adjusted as explained in the notes to exhibit 1.
Based on data from Substance Abuse and Mental Health Services Administration. 2015–2016 National Survey on Drug Use and Health (see note 32 in text).
Based on data from Centers for Disease Control and Prevention drawn by authors from the CDC Wonder database (see note 33 in text).
Based on data from Henry J. Kaiser Family Foundation. Medicaid’s role in addressing the opioid epidemic (see note 35 in text).
Trend was tested by entering the continuous variable of the number of medications covered under Medicaid (one, two, or all three) into the logistic regression models. The odds ratios associated with this variable represent changes in the odds of outcome for each additional medication covered.
Not applicable.
Based on data for 2013 from the National Drug Abuse Treatment System Survey reported in Grogan CM, et al. Survey highlights differences (see note 36 in text).
p < 0:1
p < 0:05
p < 0:01
p < 0:001