Characteristics of accountable care organizations offering methadone to patients with opioid use disorder.

Health affairs scholar Pub Date : 2025-04-09 eCollection Date: 2025-04-01 DOI:10.1093/haschl/qxaf074
Maia Crawford, Benjamin A Barsky, Haiden A Huskamp, Mary F Brunette, Ellen Meara
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Abstract

Understanding whether organizations with Medicare and Medicaid accountable care organization (ACO) contracts offer methadone provides important context about how organizations invested in payment and delivery system reform address the needs of patients with substance use disorders. We used data from the 2021-2022 National Survey of Accountable Care Organizations to assess whether organizations with ACO contracts, which are held accountable for the cost and quality of care for an assigned patient population, offered methadone to patients with opioid use disorder (OUD), and the organizational and contextual characteristics associated with doing so. We found that 28.3% of survey respondents reported that clinicians in their organizations offered methadone via an opioid treatment program. In adjusted analyses, organizations with a Medicaid ACO contract but no Medicare contract were more likely to offer methadone (46.0%, P < 0.05) than organizations with a Medicare-only contract (19.6%) or a Medicare and Medicaid contract (30.3%). Despite incentives to prioritize population health, most ACO-affiliated organizations were not offering individuals with OUD the full range of recommended medications and should work to enhance treatment options for this patient population.

向阿片类药物使用障碍患者提供美沙酮的负责任医疗机构的特点。
了解医疗保险和医疗补助责任医疗组织(ACO)合同的组织是否提供美沙酮,为组织如何投资支付和交付系统改革解决物质使用障碍患者的需求提供了重要的背景。我们使用了来自2021-2022年全国负责任医疗机构调查的数据来评估有ACO合同的组织是否向阿片类药物使用障碍(OUD)患者提供美沙酮,这些组织对指定患者群体的护理成本和质量负责,以及与此相关的组织和背景特征。我们发现28.3%的受访者报告说,他们组织的临床医生通过阿片类药物治疗项目提供美沙酮。在调整分析中,有Medicaid ACO合同但没有Medicare合同的组织比有Medicare合同(19.6%)或Medicare和Medicaid合同(30.3%)的组织更有可能提供美沙酮(46.0%,P < 0.05)。尽管鼓励优先考虑人口健康,但大多数aco附属组织并未向OUD患者提供所有推荐药物,应努力加强对这一患者群体的治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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