Medicaid participation among practitioners authorized to prescribe buprenorphine
| Autor: | Jason Lowe, Lauryn Saxe Walker, Anna Scialli, Erin Britton, Heather Saunders, Peter Cunningham, Ashley Harrell |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Nurse practitioners Medicine (miscellaneous) Logistic regression Opiate Substitution Treatment medicine Humans Practice Patterns Physicians' health care economics and organizations Medicaid business.industry Secondary data Opioid use disorder Odds ratio Opioid-Related Disorders medicine.disease United States Buprenorphine Analgesics Opioid Outreach Psychiatry and Mental health Clinical Psychology Cross-Sectional Studies Family medicine Pshychiatric Mental Health business medicine.drug |
| Zdroj: | Journal of Substance Abuse Treatment. 133:108513 |
| ISSN: | 0740-5472 |
| DOI: | 10.1016/j.jsat.2021.108513 |
| Popis: | Introduction This study examines Medicaid participation among buprenorphine waivered providers in Virginia in 2019, with a particular focus on the prescribing differences between different physician specialties, nurse practitioners and physicians assistants (NP and PA). Methods Secondary data sources include the 2019 DEA list of buprenorphine waivered prescribers, Virginia Medicaid claims for buprenorphine, physician characteristics from the Virginia Department of Health Professions, SAMHSA Behavioral Treatment Services Locator, and area level characteristics. This cross-sectional study is based on a linkage of Medicaid claims data to a list of Virginia practitioners authorized to prescribe buprenorphine in 2019. Using a two-part logistic regression, we assess prescriber license type and local area factors that are associated with: (1) the probability of prescribing buprenorphine to any Medicaid patients in 2019; (2) the number of Medicaid patients treated by each prescriber in 2019. Results Adjusted odds ratios show that nurse practitioners with buprenorphine waivers are more likely to treat any Medicaid patients compared to physicians (odds ratio (OR), 2.016; p = 0.000). Among prescribers who treated any Medicaid patients, the probability of treating a large number of Medicaid patients was higher among nurse practitioners relative to physicians (OR, 2.869, p = 0.002). Medicaid participation was much higher among prescribers with patient limits of 100 and 275 compared to prescribers with patient limits of 30 (OR, 6.66, p = 0.000 and 29.40, p = 0.000, respectively). Conclusions State Medicaid programs have been at the forefront of addressing their state's opioid epidemic, including expanding access to buprenorphine treatment. This study provides evidence that targeted outreach efforts should include NP license types as well as physicians, and is consistent with prior studies showing that NP are especially important in filling treatment gaps for underserved areas and populations. |
| Databáze: | OpenAIRE |
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