Insurance Coverage and Provision of Opioid Disorder Treatment: Evidence From Medicare
Journal of Policy Analysis and Management · 2026 · Denis Agniel、Jonathan H. Cantor、Johanna Catherine Maclean、Erin A. Taylor、Kosali Ilayperuma Simon
中文摘要
在过去二十年间,美国老年人阿片类药物过量死亡人数不断上升。美沙酮是获准用于治疗阿片类药物使用障碍(OUD)的三种药物之一,但直到2020年,Medicare——美国老年人的主要保险方——才将其纳入OUD治疗的覆盖范围。我们利用行政数据与双重差分框架,研究阿片类治疗项目(OTPs)——美国唯一能够分发美沙酮用于OUD治疗的医疗服务提供者——对这一政策变化的反应。我们发现,政策实施后,OTPs接受Medicare的比例以及美沙酮治疗轮次数均有所增加。此外,我们还记录了向其他保险市场的溢出效应,以及OTPs所提供(非美沙酮)治疗服务的变化,这表明Medicare进入该市场对在OTPs接受美沙酮治疗的所有OUD患者均有影响。
Abstract
Older adult opioid overdose deaths have increased over the past two decades in the United States. Methadone, one of three medications approved for opioid use disorder (OUD) treatment, was not covered by Medicare - the primary insurer of older Americans - for OUD until 2020. We study the response of opioid treatment programs (OTPs), the only healthcare providers that can dispense methadone for the treatment of OUD in the U.S., to this policy change using administrative data and a difference-in-differences framework. We find an increase in Medicare acceptance by OTPs and in the number of methadone treatment episodes post-policy. Further, we document spillovers to other insurance markets and changes in (non-methadone) treatment services offered by OTPs, suggesting that Medicare's entrance into this market has implications for all OUD patients receiving methadone treatment in OTPs.