The Cumulative Effect of Expanding the Breadth and Scope of Coverage for Substance Use Disorder Treatment on Behavioral Health Acute Inpatient Admissions: Evidence from Virginia Medicaid

• Published in: International journal of environmental research and public health Vol. 21; no. 6; p. 777
• Main Authors: Salehian, Shiva, Cunningham, Peter, Barnes, Andrew, Lee, Shoou-Yih Daniel
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.06.2024; MDPI
• Subjects: Adult; Beneficiaries; Codes; Drug use; Female; Health care access; Health services; Hospitalization - statistics & numerical data; Hospitals; Humans; Indigent care; Inpatients - statistics & numerical data; Low income groups; Male; Medicaid; Medicaid - statistics & numerical data; Mental disorders; Mental health; Mental institutions; Middle Aged; Narcotics; Patients; Substance abuse treatment; Substance use disorder; Substance-Related Disorders - therapy; Uninsured people; United States; Virginia; Waivers; United States; Virginia; United States > US; acute inpatient care; Medicaid; mental health
• ISSN: 1661-7827; 1660-4601; 1660-4601
• DOI: 10.3390/ijerph21060777

We evaluated the impact of Medicaid policies in Virginia (VA), namely the Addiction and Recovery Treatment Services (ARTS) program and Medicaid expansion, on the number of behavioral health acute inpatient admissions from 2016 to 2019. We used Poisson fixed-effect event study regression and compared average proportional differences in admissions over three time periods: (1) prior to ARTS; (2) following ARTS but before Medicaid expansion; (3) post-Medicaid expansion. The number of behavioral health acute inpatient admissions decreased by 2.6% (95% CI [-5.1, -0.2]) in the first quarter of 2018 and this decrease gradually intensified by 4.9% (95% CI [-7.5, -2.4]) in the fourth quarter of 2018 compared to the second quarter of 2017 (beginning of ARTS) in VA relative to North Carolina (NC). Following the first quarter of 2019 (beginning of Medicaid expansion), decreases in VA admissions became larger relative to NC. The average proportional difference in admissions estimated a decrease of 2.7% (95% CI, [-4.1, -0.8]) after ARTS but before Medicaid expansion and a decrease of 2.9% (95% CI, [-6.1, 0.4]) post-Medicaid expansion compared to pre-ARTS in VA compared to NC. Behavioral health acute inpatient admissions in VA decreased following ARTS implementation, and the decrease became larger after Medicaid expansion.