Working Paper: NBER ID: w31884
Authors: Denis Agniel; Jonathan H. Cantor; Johanna Catherine Maclean; Kosali I. Simon; Erin Taylor
Abstract: Opioid overdose deaths in older adults increased substantially over the past two decades. This increase occurred despite the availability of effective treatments. 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 OUD in the U.S., to this policy change using administrative data and a difference-in-differences framework. We examine provider acceptance of Medicare payment and the number of treatment episodes, before and after the policy change, in OTPs relative to other substance use disorder treatment facilities. Our findings show a surge in Medicare acceptance by OTPs and an increase in the number of treatment episodes post-policy, signalling the importance of insurance for OUD treatment provision.
Keywords: Opioid Use Disorder; Medicare; Methadone; Healthcare Policy
JEL Codes: I11; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Medicare policy change (I18) | Other insurance markets and charity care provision (G52) |
| Medicare policy change (I18) | Acceptance of Medicare payment by OTPs (I18) |
| Medicare policy change (I18) | Treatment episodes among older adults with OUD in OTPs (J26) |
| Acceptance of Medicare payment by OTPs (I18) | Treatment episodes among older adults with OUD in OTPs (J26) |