Evaluating the role of Section 1115 waivers on Medicaid coverage and utilization of opioid agonist therapy among substance use treatment admissions

Objective

To examine the impact of Section 1115 waivers on Medicaid coverage and opioid agonist therapy (OAT) utilization among substance use treatment admissions.

Data Source

Treatment Episode Data Set‐Admissions (TEDS‐A) (2001‐2012).

Study Design

We examined effects of 1115 waiver implementation on proportions of substance use treatment admissions with Medicaid and receiving OAT, using random intercept linear regression.

Principal Findings

1115 waiver implementation was associated with an average of a 6 percentage point increase in proportion of all admissions with Medicaid, and 4 percentage point increase among opioid outpatient admissions. Implementation was not associated with change in proportion of opioid outpatient admissions receiving OAT.

Conclusions

1115 waivers influence Medicaid coverage among substance use treatment admissions. The findings improve our understanding of how state policies impact substance use treatment utilization.