Presentation Recap: NCQA Opioid Addiction Study Makes Clear the Health Equity Crisis

June 17, 2021 · NCQA Communications

The more we look for them, the more we find that issues with Health Equity present a huge challenge in the United States.

A recent study presented by NCQA Research Scientist Dr. Judy Ng makes it clear: historically underserved racial groups are still among the most vulnerable when it comes to getting the health care they need.

Nowhere is this more obvious than in fight against opioid addiction.

Using 2018 stats from the Centers for Medicare and Medicaid Services (CMS) the study, titled “Access to Medications for Opioid Use Disorder among Medicare Fee-for-Service Beneficiaries: Where are the Gaps?”, tells the tale of Opioid Use Disorder [OUD] and its treatment in the U.S. the past few years. This study revealed that nearly 3% of Americans on Medicare had diagnosed OUD.  But of all the patients qualifying for medications to treat OUD, only 14% accessed those treatments.

There were also huge gaps in equitable access to medication treatment. Among people with Medicare insurance, those diagnosed with OUD were disproportionately Black/African-American, under 65, and with more complex health needs, such as a higher number of health conditions. Moreover, access to meds for OUD was much lower among Black/African-Americans and those with more complex health needs. However, there were fewer gaps in medication treatment among people who lived in states with policies supporting access to medications, such as expanded treatment coverage.

As NCQA continues to explore gaps in Health Equity today, it becomes clear that more targeted federal efforts are needed to resolve access to care issues. We can see here how historically underserved populations not only make up a huge portion of those suffering from opioid addiction in the United States, but also a disproportionate percentage of those not receiving any treatment for their addictions.

So what’s working and what can still be done to start bridging the gap in Health Equity?

While it is possible that those not receiving OUD treatment might be prioritizing treatment for other comorbidities, particularly physical health-related conditions, there are a number of high-level efforts that could alleviate treatment gaps.

• Make both Medicare and Medicaid available to more underserved patients;
• Encourage more state-level support for treatment among underserved populations;
• Improve integration of treatment and coverage for mental and physical health issues, i.e. fusing mental health services with primary physical care.

Dr. Ng’s team sees the clear benefits of state policies supporting easing accessibility to OUD treatments as well as increased support for accessibility to health care of all kinds on the federal level. But more needs to be done all around the board to get treatment for addiction to those who need it, regardless of who they are or where they live.

To learn more, see the poster for Access to Medications for Opioid Use Disorder Among Medicare Fee-for-Service Beneficiaries: Where Are the Gaps?

This study was one four reports NCQA staff presented at the AcademyHealth Annual Research Meeting on June 15, 2021. Others were:

• Predictors of Chronic Pain Diagnosis and Treatment Among Adult Federally Qualified Health Center Patients
• COVID-19 Disrupted Skilled Nursing Facility Utilization and Outcomes across Medicare Advantage Enrollee Subgroups
• Trends in Timely Follow-up after Hospitalization, Adoption of Telehealth, and Association with 30-Day Readmission: Impact of the COVID-19 Public Health Emergency
• Quality of Behavioral Health Services and Integration with Primary Care

The primary source of funding for this study was from the Centers for Medicare and Medicaid Services.