دورية أكاديمية
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How Does Medicaid Managed Care Address the Needs of Beneficiaries with Opioid Use Disorders? A Deep Dive into Contract Design.

التفاصيل البيبلوغرافية
العنوان: How Does Medicaid Managed Care Address the Needs of Beneficiaries with Opioid Use Disorders? A Deep Dive into Contract Design.
المؤلفون: Morris R; Department of Health Policy & Management, George Washington University, Washington, D.C., USA., Rosenbaum S; Milken Institute School of Public Health, George Washington University, Washington, D.C., USA., Grogan C; Crown Famiy School, University of Chicago, Chicago, IL, USA., Rhodes M; Arnold School of Public Health, University of South Carolina, Columbia, SC, USA., Andrews C; Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
المصدر: American journal of law & medicine [Am J Law Med] 2023 Jul; Vol. 49 (2-3), pp. 339-348. Date of Electronic Publication: 2024 Feb 12.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Cambridge University Press Country of Publication: England NLM ID: 7509572 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0098-8588 (Print) Linking ISSN: 00988588 NLM ISO Abbreviation: Am J Law Med Subsets: MEDLINE
أسماء مطبوعة: Publication: 2021- : [Cambridge] : Cambridge University Press
Original Publication: Boston : American Society of Law & Medicine
مواضيع طبية MeSH: State Health Plans* , Opioid-Related Disorders*, United States ; Humans ; Medicaid ; Managed Care Programs
مستخلص: Many people who experience opioid use disorder rely on Medicaid. The high penetration of managed care systems into Medicaid raises the importance of understanding states' expectations regarding coverage, access to care, and health system performance and effectively elevates agreements between states and plans into blueprints for coverage and care. Federal law broadly regulates these structured agreements while leaving a high degree of discretion to states and plans. In this study, researchers reviewed the provisions of 15 state Medicaid managed care contract related to substance use disorder (SUD) treatment to identify whether certain elements of SUD treatment were a stated expectation and the extent to which the details of those expectations varied across states in ways that ultimately could affect evaluation of performance and health outcomes. We found that while all states include SUD treatment as a stated contract expectation, discussions around coverage of specific services and nationally recognized guidelines varied. These variations reflect key state choices regarding how much deference to afford their plans in coverage design and plan administration and reveal important differences in purchasing expectations that could carry implications for efforts to examine similarities and differences in access, quality, and health outcomes within managed care across the states.
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معلومات مُعتمدة: R01 DA052425 United States DA NIDA NIH HHS
فهرسة مساهمة: Keywords: Medicaid; coverage; insurance; substance use
تواريخ الأحداث: Date Created: 20240212 Date Completed: 20240214 Latest Revision: 20240903
رمز التحديث: 20240904
مُعرف محوري في PubMed: PMC11185417
DOI: 10.1017/amj.2023.35
PMID: 38344786
قاعدة البيانات: MEDLINE
الوصف
تدمد:0098-8588
DOI:10.1017/amj.2023.35