Study Finds Medicaid Waivers for Inpatient/Residential Treatment Not Associated with Overall Improvements in Nonfatal Overdoses or Treatment for Opioid Use Disorder

States that received waivers allowing Medicaid to pay for mental health and substance use treatment in large residential facilities did not see an overall benefit in terms of increased medication treatment or a decrease in nonfatal overdoses, a new study finds.

In 2015, the federal government allowed states to waive a longstanding prohibition against using federal Medicaid funds for services in these facilities (Institutions for Mental Diseases, or IMDs, facilities with more than 16 beds that specialize in mental health or substance use treatment). n turn, states were required to improve their substance use disorder care, emphasizing treatment with medications.

In the new study, researchers at Oregon Health & Science University found no overall benefit in terms of increased medication treatment or decrease in nonfatal overdoses in the 17 states that received waivers between 2017 and 2019, compared with 18 states that did not receive waivers.

“The waivers have been important to update Medicaid’s program to treat opioid use disorder, however they alone do not appear to have meaningfully improved the situation in terms of uptake of medication to treat opioid use disorders or in reducing overdoses,” lead author Stephan Lindner, Ph.D. said in a university news release. “We have made some progress in addressing the opioid crisis, but we need more substantial action at the federal level to make sure all people with opioid use disorder get the treatment they need,” Lindner said.