Table 2. Telehealth, Medications for Opioid Use Disorder (MOUD) Receipt and Retention, and Medically Treated Overdose Among Medicare Fee-for-Service Beneficiaries With Opioid Use Disorder (OUD).
| Measure | No. (%) | P valuea | |
|---|---|---|---|
| Pre–COVID-19 pandemic cohort (n = 105 240) | COVID-19 pandemic cohort (n = 70 538) | ||
| Receipt of telehealth services | |||
| Receipt of telehealth services at baseline visit | |||
| Any telehealth service | 212 (0.20) | 9782 (13.87) | <.001 |
| Behavioral health-related telehealth service | 179 (0.17) | 8704 (12.34) | <.001 |
| OUD-related telehealth service | 125 (0.12) | 8516 (12.07) | <.001 |
| Receipt of telehealth services from baseline visit through follow-up period | |||
| Any telehealth service | 2594 (2.46) | 48 390 (68.60) | <.001 |
| Behavioral health-related telehealth service | 1967 (1.87) | 28 902 (40.97) | <.001 |
| OUD-related telehealth service | 593 (0.56) | 13 829 (19.61) | <.001 |
| Receipt of MOUD | |||
| Receipt of MOUD at baseline visit | |||
| Any MOUD from OTP or pharmacy | 4667 (4.43) | 5321 (7.54) | <.001 |
| Any MOUD from OTP | 0 | 2087 (2.96) | <.001 |
| Buprenorphine from OTP | 0 | 87 (0.12) | <.001 |
| ER naltrexone from OTP | 0 | 0 | |
| Methadone from OTP | 0 | 2002 (2.84) | <.001 |
| Any MOUD from pharmacy | 4667 (4.43) | 3242 (4.60) | .11 |
| Buprenorphine from pharmacy | 4566 (4.34) | 3184 (4.51) | .08 |
| ER naltrexone from pharmacy | 102 (0.10) | 58 (0.08) | .32 |
| Receipt of MOUD from baseline visit through follow-up period | |||
| Any MOUD from OTP or pharmacy | 11 360 (10.79) | 8854 (12.55) | <.001 |
| Any MOUD from OTP | 1451 (1.38) | 2837 (4.02) | <.001 |
| Buprenorphine from OTP | 44 (0.04) | 161 (0.23) | <.001 |
| ER naltrexone from OTP | 0 | 1 (0.00) | .22 |
| Methadone from OTP | 1419 (1.35) | 2719 (3.85) | <.001 |
| Any MOUD from pharmacy | 9990 (9.49) | 6174 (8.75) | <.001 |
| Buprenorphine from pharmacy | 9675 (9.19) | 6005 (8.51) | <.001 |
| ER naltrexone from pharmacy | 369 (0.35) | 198 (0.28) | .01 |
| MOUD retention among those receiving MOUD | |||
| Buprenorphine from pharmacies only | |||
| Proportion of eligible days covered, mean (SD) | 0.51 (0.34) | 0.52 (0.34) | .13 |
| Proportion of eligible days covered, median (IQR) | 0.55 (0.15-0.84) | 0.56 (0.15-0.86) | .03 |
| Beneficiaries with ≥80% adherence, % | 31.07 | 33.26 | .005 |
| ER naltrexone from pharmacies only | |||
| Proportion of eligible days covered, mean (SD) | 0.35 (0.26) | 0.37 (0.28) | .44 |
| Proportion of eligible days covered, median (IQR) | 0.29 (0.12-0.51) | 0.30 (0.12-0.56) | .60 |
| Beneficiaries with ≥80% adherence, % | 7.94 | 11.83 | .16 |
| MOUD from OTPs only | |||
| Proportion of eligible days covered | |||
| Mean (SD) | 0.16 (0.06) | 0.69 (0.30) | <.001 |
| Median (IQR) | 0.16 (0.13-0.20) | 0.81 (0.46-0.96) | <.001 |
| Beneficiaries with ≥80% adherence, % | 0.00 | 50.93 | <.001 |
| MOUD from OTPs and pharmacies | |||
| Proportion of eligible days covered | |||
| Mean (SD) | 0.29 (0.17) | 0.58 (0.27) | <.001 |
| Median (IQR) | 0.25 (0.17-0.38) | 0.65 (0.38-0.80) | <.001 |
| Beneficiaries with ≥80% adherence, % | 2.47 | 26.11 | <.001 |
| Medically treated overdose from index period through follow-up period | |||
| Any medically treated overdose | 19 491 (18.52) | 13 004 (18.44) | .65 |
Abbreviations: ER, extended-release; OTP, opioid treatment program.
a
To assess differences between cohorts, we used χ2 tests for proportions and percentages, t tests for means, and the Wilcoxon signed rank test for medians.