Medicaid expansion and opioid prescriptions: Evidence from the Medical Expenditure Panel Survey.

Evidence is mixed on whether increased access to insurance, specifically through the ACA's Medicaid expansion, exacerbated the opioid public health crisis through increased opioid prescribing. Using survey data on retail prescription drug fills from 2008 to 2019, we did not find a significant relationship between Medicaid expansion and opioid prescribing in the newly eligible Medicaid population. It may be that the dangers of opioids were known well enough by the time of the Medicaid expansion that lack of access to care was no longer a binding constraint on opioid prescription receipt.

Health care Utilization and Expenditures in Health Professional Shortage Areas.

Healthcare provider shortages are associated with adverse health outcomes, presumably stemming from the lack of access to primary care. This study examines the impact of Health Professional Shortage Areas (HPSAs) on healthcare utilization and spending across different types of care. Using the Medical Expenditure Panel Survey from 2002 to 2019, this study estimates the difference in healthcare utilization in HPSAs compared with non-HPSAs using a generalized random forest, which allows for more complex modeling of the outcome and a principled examination of heterogenous treatment effects.

Mental Health Impairment and Outpatient Mental Health Care of US Children and Adolescents.

Importance: Despite a federal declaration of a national child and adolescent mental health crisis in 2021, little is known about recent national trends in mental health impairment and outpatient mental health treatment of US children and adolescents.

Objective: To characterize trends in mental health impairment and outpatient mental health care among US children and adolescents from 2019 to 2021 across demographic groups and levels of impairment.

Design, Setting, And Participants: Survey study with a repeated cross-sectional analysis of mental health impairment and outpatient mental health care use among youth (ages 6-17 years) within the 2019 and 2021 Medical Expenditure Panel Surveys, nationally representative surveys of US households.

Trends in Psychological Distress and Outpatient Mental Health Care of Adults During the COVID-19 Era.

Background: In addition to the physical disease burden of the COVID-19 pandemic, concern exists over its adverse mental health effects.

Objective: To characterize trends in psychological distress and outpatient mental health care among U.S.

Medicaid reimbursement rates for primary care services and behavioral health outcomes.

We study the effects of changing Medicaid reimbursement rates for primary care services on behavioral health outcomes-defined here as mental illness and substance use disorders. Medicaid enrollees are at elevated risk for these, and other, chronic conditions and are likely to have unmet treatment needs. We apply two-way fixed-effects regressions to survey data specifically designed to measure behavioral health outcomes over the period 2010-2016.

Using machine-learning algorithms to improve imputation in the medical expenditure panel survey.

Objective: To assess the feasibility of applying machine learning (ML) methods to imputation in the Medical Expenditure Panel Survey (MEPS).

Data Sources: All data come from the 2016-2017 MEPS.

Study Design: Currently, expenditures for medical encounters in the MEPS are imputed with a predictive mean matching (PMM) algorithm in which a linear regression model is used to predict expenditures for events with (donors) and without (recipients) data.

Recreational marijuana laws and the misuse of prescription opioids: Evidence from National Survey on Drug Use and Health microdata.

Several studies have concluded that legalizing medical marijuana can reduce deaths from opioid overdoses. Drawing on micro data from the National Survey on Drug Use and Health, a survey uniquely suited to assessing patterns of substance use, we examine the relationship between recreational marijuana laws (RMLs) and the misuse of prescription opioids. Using a standard difference-in-differences (DD) regression model, we find that RML adoption reduces the likelihood of frequently misusing prescription opioids such as OxyContin, Percocet, and Vicodin.

Effects of Medicaid expansion on insurance coverage and health services use among adults with disabilities newly eligible for Medicaid.

Objective: To estimate the effects of Affordable Care Act (ACA) Medicaid expansion on insurance and health services use for adults with disabilities who were newly eligible for Medicaid.

Data Sources: 2008-2018 Medical Expenditure Panel Survey data.

Study Design: We used the Agency for Healthcare Research and Quality (AHRQ) PUBSIM model to identify adults aged 26-64 years with disabilities who were newly Medicaid-eligible in expansion states or would have been eligible in non-expansion states had those states opted to expand.

Users of retail medications for opioid use disorders faced high out-of-pocket prescription spending in 2011-2017.

Introduction: High out-of-pocket spending has been a barrier to treatment for the estimated 2.0 million Americans suffering from opioid use disorders (OUD). This paper provides national estimates of financial costs faced by the population receiving retail medications for OUD (MOUD).

LETTER: Medicaid Expansion and Mental Health Care and Coverage: Reply.

No abstract available.

Medicaid Expansion and Health Insurance Coverage and Treatment Utilization among Individuals with a Mental Health Condition.

Background: The Affordable Care Act (ACA) gives states the option of expanding Medicaid coverage to low-income individuals; however, not all states have chosen to expand Medicaid. The ACA Medicaid expansions are particularly important for Americans with mental health conditions because they are substantially more likely than other Americans to have low incomes.

Aims Of The Study: We examine the impact of Medicaid expansion on adults who were newly eligible for Medicaid using the 2008-2017 Medical Expenditure Panel Survey (MEPS).

Medical Marijuana Laws, Marijuana Use, and Opioid-Related Outcomes among Women in the United States.

Background: In the context of the opioid epidemic, a limited but growing body of literature has found state medical marijuana laws (MMLs) to be associated with lower levels of opioid prescribing. However, robust evidence linking state MMLs with individual-level opioid-related outcomes is lacking, particularly among women. This finding is especially true for pregnant and parenting women, who have been disproportionately affected by the opioid crisis.

Physician networks and potentially inappropriate opioid prescriptions.

Opioid overdose is a national health priority and curbing inappropriate prescribing is critical. In 2016, the Centers for Disease Control and Prevention (CDC) issued appropriate prescribing guidelines. Examine associations between care networks defined by shared patients and problematic opioid prescribing.

Integrated care models and behavioral health care utilization: Quasi-experimental evidence from Medicaid health homes.

Integration of behavioral and general medical care can improve outcomes for individuals with behavioral health conditions-serious mental illness (SMI) and substance use disorder (SUD). However, behavioral health care has historically been segregated from general medical care in many countries. We provide the first population-level evidence on the effects of Medicaid health homes (HH) on behavioral health care service use.

The impact of the abuse-deterrent reformulation of extended-release OxyContin on prescription pain reliever misuse and heroin initiation.

The introduction of abuse-deterrent OxyContin in 2010 was intended to reduce its misuse by making it more tamper resistant. However, some studies have suggested that this reformulation might have had unintended consequences, such as increases in heroin-related deaths. We used the 2005-2014 cross-sectional U.

Price elasticity of demand for buprenorphine/naloxone prescriptions.

Although there have been supply-side efforts in response to the opioid crisis (e.g., prescription drug monitoring programs), little information exists on demand-side approaches related to patient cost sharing that may affect utilization of and adherence to pharmacotherapy by individuals with opioid use disorder.

Disparities in opioid related mortality between United States counties from 2000 to 2014.

Background: The general increase in opioid-related deaths is well documented, and disparities by geographic regions and demographic characteristics have been observed as well. However, the distribution of opioid-related deaths among U.S.

Behavioral Health's Integration Within a Care Network and Health Care Utilization.

Objective: Examine how behavioral health (BH) integration affects health care costs, emergency department (ED) visits, and inpatient admissions.

Data Sources/study Setting: Truven Health MarketScan Research Databases.

Study Design: Social network analysis identified "care communities" (providers sharing a high number of patients) and measured BH integration in terms of how connected, or central, BH providers were to other providers in their community.

Opioid-overdose laws association with opioid use and overdose mortality.

Introduction: Since the 1990's, governmental and non-governmental organizations have adopted several measures to increase access to the opioid overdose reversal medication naloxone. These include the implementation of laws that increase layperson naloxone access and overdose-specific Good Samaritan laws that protect those reporting overdoses from criminal sanction. The association of these legal changes with overdose mortality and non-medical opioid use is unknown.

The Affordable Care Act's Dependent Care Coverage Expansion and Behavioral Health Care.

Background: In September 2010, the Affordable Care Act (ACA) extended dependent care coverage to individuals under the age of 26, allowing young adults to remain on their parent's private insurance.

Aims Of The Study: This policy offers a natural experiment to examine the impact of expanded insurance coverage on mental health and substance use treatment utilization and payment composition.

Methods: Using National Survey on Drug Use and Health (NSDUH) and Medical Expenditure Panel Survey (MEPS) data between 2005 and 2014, this study employs a difference-in-differences approach with 23-25 year olds as the treatment group and 27-30 year olds as the control group to examine the impact of the expansion on insurance coverage, behavioral health treatment utilization, and treatment payment source.

The Affordable Care Act's Dependent Care Coverage and Mortality.

Background: In September 2010, the Affordable Care Act (ACA) enabled young adults to gain insurance coverage under their parents' policies.

Objective: Assess the impact of the ACA's dependent care coverage expansion on young adult mortality rates.

Research Design: Using the Multiple Cause Mortality public use database for 2008-2013, the impact of the ACA is examined with a difference-in-differences analysis of monthly mortality rates using individuals aged 26-30 as a natural control group for young adults aged 19-25.