Working Paper: NBER ID: w29001
Authors: Eric Barrette; Leemore Dafny; Karen Shen
Abstract: Even among commercially-insured individuals, opioid use disorder (OUD) is undertreated in the U.S.: nearly half receive no treatment within 6 months of a new diagnosis. Using a difference-in-differences specification exploiting the extension of insurance parity requirements for substance disorder treatment to small group enrollees in 2014, we find that parity increases utilization of residential treatment but decreases utilization of agonist medications, the standard of care. We find direct interventions to increase access to medication may be more promising: increases in the county-level share of physicians able to prescribe agonists are associated with substitution toward medication-assisted treatment.
Keywords: opioid use disorder; treatment access; insurance parity; medication-assisted treatment
JEL Codes: H51; I1; I12; I13; I28
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Extension of insurance parity laws (G52) | Increase in utilization of residential treatment (R28) |
| Extension of insurance parity laws (G52) | Decrease in utilization of medication-assisted treatment (MAT) (I19) |
| Extension of insurance parity laws (G52) | No significant change in overall propensity to receive any treatment (C22) |
| Increase in county-level share of physicians able to prescribe buprenorphine (I14) | Greater utilization of medication-assisted treatment (MAT) (I19) |