The Impact of Medicaid Plans on Access to and Quality of SUD Treatment

医疗补助计划对 SUD 治疗的获取和质量的影响

基本信息

批准号：
9906863
负责人：
MARGARITA ALEGRIA
金额：
$ 52.81万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-01 至 2021-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9906863
关键词：
Address Adoption Affect Alcohol consumption American Caring Contracts Country Data Disabled Persons Drug Use Disorder Early Diagnosis Enrollment Ensure Ethnic Origin Fee-for-Service Plans Foundations Gender Goals Health Insurance Health Services Accessibility Healthcare Healthcare Systems Hospitals Individual Insurance Carriers Interview Low income Managed Care Managed Care Programs Medicaid Medicaid services Methods Minority Natural experiment New York Outcome Patients Pattern Patterns of Care Performance Persons Policies Population Preventive Privatization Provider Qualitative Methods Race Research Role Rural Services Smoking Cessation Intervention Structure Subgroup Substance Use Disorder System Time Tobacco Use Cessation Tobacco use addiction behavioral health care outcomes combat effective therapy ethnic minority population evidence base experience health management health plan improved innovation insight medical specialties member programs public health priorities racial and ethnic rurality treatment services urban area

项目摘要

PROJECT SUMMARY Medicaid, the largest health insurance sector in the U.S., with the most vulnerable individuals, is the least- well understood. There is little research on the effects of the structure of state Medicaid programs on access, patterns of care and outcomes of substance use disorder (SUD) care. States provide Medicaid benefits either through publicly managed Fee-for-Service (FFS) systems or by contracting with private Medicaid Managed Care (MMC) plans. Despite widespread adoption of MMC, its role is not well-understood, especially its effects on SUD treatment and service disparities. Little is known about any differences in SUD treatment between traditional FFS Medicaid and private MMC plans or differences across different types of managed care plans with different approaches to SUD treatment. The proposed study makes use of innovative random assignment methods to address this challenge in the Medicaid sector. In the proposed project, we apply a select group of metrics for assessing access, patterns of care and outcomes of SUD treatment, to describe the performance of systems, health plans, and provider groups in New York. We then conduct stratified analysis by race/ethnicity, gender, and rurality to identify which programs and plans have better outcomes and identify if there are service disparities. Our project uses qualitative methods to help interpret our results through in-depth interviews, and to provide insight on the interpretation of findings and suggest practice and policy changes.

项目摘要医疗补助是美国最大的健康保险部门，最脆弱的人是最不脆弱的人 - 理解。关于国家医疗补助计划对访问的结构的影响，几乎没有研究，护理模式和药物使用障碍（SUD）护理的结果。国家提供医疗补助福利通过公开管理的费用服务（FFS）系统或与私人医疗补助管理护理（MMC）计划。尽管MMC广泛采用，但其作用并不是很好地理解，尤其是其效果关于SUD治疗和服务差异。关于SUD治疗之间的任何差异知之甚少传统的FFS医疗补助和私人MMC计划或不同类型的托管护理计划的差异采用不同的SUD治疗方法。拟议的研究利用创新的随机分配在医疗补助领域解决这一挑战的方法。在拟议的项目中，我们应用了一组评估访问访问，护理模式和SUD治疗结果的指标，以描述纽约的系统，健康计划和提供商团体。然后，我们按种族/种族进行分层分析，性别和乡村以确定哪些计划和计划具有更好的结果，并确定是否有服务差异。我们的项目使用定性方法来通过深入的访谈来解释我们的结果，并提供有关发现的解释并提出实践和政策变化的见解。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Racial/Ethnic Disparities in Substance Use Treatment in Medicaid Managed Care in New York City: The Role of Plan and Geography.

DOI：
10.1097/mlr.0000000000001768
发表时间：
2022-11-01
期刊：
MEDICAL CARE
影响因子：
3
作者：
Alegria, Margarita;Falgas-Bague, Irene;Fukuda, Marie;Zhen-Duan, Jenny;Weaver, Cole;O'Malley, Isabel;Layton, Timothy;Wallace, Jacob;Zhang, Lulu;Markle, Sheri;Lincourt, Pat;Hussain, Shazia;Lewis-Fernandez, Roberto;John, Dolly A.;McGuire, Thomas
通讯作者：
McGuire, Thomas

Performance Metrics of Substance Use Disorder Care Among Medicaid Enrollees in New York, New York.