Study Finds No Improvement in Addiction Treatment Initiation and Engagement Rates Among Medicaid and Private Health Plans

Although rates of identification of substance use disorders improved, there was no improvement in rates of initiation or engagement in substance use disorder treatment between 2010 and 2016

Highlights

  • The study found that identification of substance use disorders among commercial health care plans significantly increased from 3.3% to 6.7% between 2010 and 2016.
  • However, the study also found that for commercial plans, initiation rates declined from 41.9% to 33.7%, and engagement rates declined from 15.8% to 12.1% in the same time period.
  • new study found that although identification of substance use disorders (SUDs) increased among both commercial and Medicaid health plans between 2010 and 2016, the majority of the individuals identified did not initiate SUD treatment and only a small portion of individuals who initiated treatment stayed engaged in SUD treatment. For commercial plans, initiation and engagement rates declined between 2010 and 2016, and for Medicaid plans, they remained relatively stable, revealing no improvement in treatment among health plan members. RTI expert Tami Mark, PhD, co-authored the study, which was published in Psychiatry Services earlier this week.

    The study used data submitted by about 400 commercial and 100 Medicaid plans to the National Committee for Quality Assurance. The researchers used three performance measures—identification, initiation, and engagement in SUD treatment—to determine whether care for individuals with SUDs improved over time. Prior studies have demonstrated that initiation and engagement in SUD treatment reduces the risk of overdose death and improves functioning.

    The study found that identification of substance use disorders significantly increased from 1.0% to 1.6% and 3.3% to 6.7% for commercial and Medicaid plans, respectively, but the increased proportion did not correlate with increased rates of initiation or engagement in treatment. In fact, for commercial plans, initiation rates declined from 41.9% to 33.7%, and engagement rates declined from 15.8% to 12.1%. The rates remained relatively stable for Medicaid plans, indicating no significant deterioration or improvement during the time period.

    “These results reveal that we still have a lot of work to do to improve SUD treatment quality. Despite the increased focus on addiction, health plans are not rapidly improving on measures of addiction treatment quality: initiating people into addiction treatment and keeping them engaged,” said Dr. Mark.

    RTI has been on the forefront of efforts to improve addiction treatment quality by helping develop systems that consumers can use to find high quality treatment providers, developing quality measures that focus on outcomes, and conducting research on factors that influence retention in treatment.

    Learn more about RTI’s work in behavioral health and the measurement and evaluation of SUD treatment.