{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:33:10Z","timestamp":1789115590720,"version":"build-2803163510"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>A significant proportion of Medicare beneficiaries have a diagnosed opioid use disorder (OUD). Methadone and buprenorphine are both effective medications for the treatment of OUD (MOUDs); however, Medicare did not cover methadone until 2020.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine trends in methadone and buprenorphine dispensing among Medicare Advantage (MA) enrollees after 2 policy changes in 2020 related to methadone access.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional analysis of temporal trends in methadone and buprenorphine treatment dispensing assessed MA beneficiary claims from January 1, 2019, through March 31, 2022, captured by Optum\u2019s Clinformatics Data Mart. Of 9\u202f870\u202f791 MA enrollees included in the database, 39\u202f252 had at least 1 claim for methadone, buprenorphine, or both during the study period. All available MA enrollees were included. Subanalyses by age and dual eligibility for Medicare and Medicaid status were conducted.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Study exposures were (1) the Centers for Medicare &amp;amp; Medicaid Services (CMS) Medicare bundled payment reimbursement policy for OUD treatment and (2) the Substance Abuse and Mental Health Administration and CMS Medicare policies designed to facilitate access to treatment for OUD, specifically during the COVID-19 pandemic.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Study outcomes were trends in methadone and buprenorphine dispensing by beneficiary characteristics. National methadone and buprenorphine dispensing rates were calculated as claims-based dispensing rates per 1000 MA enrollees.<\/jats:p><\/jats:sec>Results<\/jats:title>Among the 39\u202f252 MA enrollees with at least 1 MOUD dispensing claim (mean age, 58.6 [95% CI, 58.57-58.62] years; 45.9% female), 195\u202f196 methadone claims and 540\u202f564 buprenorphine pharmacy claims were identified, for a total of 735\u202f760 dispensing claims. The methadone dispensing rate for MA enrollees was 0 in 2019 because the policy did not allow any payment until 2020. Claims rates per 1000 MA enrollees were low initially, increasing from 0.98 in the first quarter of 2020 to 4.71 in the first quarter of 2022. Increases were primarily associated with dually eligible beneficiaries and beneficiaries younger than 65 years. National buprenorphine dispensing rates were 4.64 per 1000 enrollees in quarter 1 of 2019, increasing to 7.45 per 1000 enrollees in quarter 1 of 2022.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This cross-sectional study found that methadone dispensing increased among Medicare beneficiaries after the policy changes. Rates of buprenorphine dispensing did not provide evidence that beneficiaries substituted buprenorphine for methadone. The 2 new CMS policies represent an important first step in increasing access to MOUD treatment for Medicare beneficiaries.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.14328","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T15:31:13Z","timestamp":1684510273000},"page":"e2314328","source":"Crossref","is-referenced-by-count":23,"title":["Trends in Methadone Dispensing for Opioid Use Disorder After Medicare Payment Policy Changes"],"prefix":"10.1001","volume":"6","author":[{"given":"Erin A.","family":"Taylor","sequence":"first","affiliation":[{"name":"RAND Corporation, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Cantor","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley C.","family":"Bradford","sequence":"additional","affiliation":[{"name":"The Paul H. O\u2019Neill School of Public and Environmental Affairs, Indiana University, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosali","family":"Simon","sequence":"additional","affiliation":[{"name":"The Paul H. O\u2019Neill School of Public and Environmental Affairs, Indiana University, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley D.","family":"Stein","sequence":"additional","affiliation":[{"name":"RAND Corporation, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,5,19]]},"reference":[{"issue":"3","key":"zoi230438r2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.7326\/M17-3107","article-title":"Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: a cohort study.","volume":"169","author":"Larochelle","year":"2018","journal-title":"Ann Intern Med"},{"key":"zoi230438r3","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.jsat.2016.05.002","article-title":"Impact of medication-assisted treatment for opioid addiction on Medicaid expenditures and health services utilization rates in Vermont.","volume":"67","author":"Mohlman","year":"2016","journal-title":"J Subst Abuse Treat"},{"issue":"5","key":"zoi230438r4","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1377\/hlthaff.2019.01085","article-title":"Impact of long-term buprenorphine treatment on adverse health care outcomes in Medicaid.","volume":"39","author":"Samples","year":"2020","journal-title":"Health Aff (Millwood)"},{"issue":"2","key":"zoi230438r5","doi-asserted-by":"publisher","first-page":"e1920622","DOI":"10.1001\/jamanetworkopen.2019.20622","article-title":"Comparative effectiveness of different treatment pathways for opioid use disorder.","volume":"3","author":"Wakeman","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi230438r8","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002209","article-title":"Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence.","author":"Mattick","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"zoi230438r9","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1377\/hlthaff.2019.00309","article-title":"Gaps in access to opioid use disorder treatment for Medicare beneficiaries.","volume":"39","author":"Harris","year":"2020","journal-title":"Health Aff (Millwood)"},{"issue":"3","key":"zoi230438r10","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1176\/appi.ps.201700137","article-title":"Methadone maintenance treatment for older adults: cost and logistical considerations.","volume":"69","author":"Cotton","year":"2018","journal-title":"Psychiatr Serv"},{"issue":"6","key":"zoi230438r16","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1016\/j.amepre.2021.01.010","article-title":"Trends in opioid use disorder among older adults: analyzing Medicare data, 2013-2018.","volume":"60","author":"Shoff","year":"2021","journal-title":"Am J Prev Med"},{"issue":"4","key":"zoi230438r17","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.7964","article-title":"Association of duration of methadone or buprenorphine use during pregnancy with risk of nonfatal drug overdose among pregnant persons with opioid use disorder in the US.","volume":"5","author":"Jarlenski","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"6","key":"zoi230438r20","doi-asserted-by":"publisher","first-page":"2143","DOI":"10.1111\/hesr.2008.43.issue-6","article-title":"Dosage patterns in methadone treatment: results from a national survey, 1988-2005.","volume":"43","author":"Pollack","year":"2008","journal-title":"Health Serv Res"},{"key":"zoi230438r21","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.jsat.2018.10.006","article-title":"Evidence-based treatment for opioid use disorders: a national study of methadone dose levels, 2011-2017.","volume":"96","author":"D\u2019Aunno","year":"2019","journal-title":"J Subst Abuse Treat"},{"issue":"4","key":"zoi230438r22","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/PHH.0000000000001262","article-title":"addressing barriers to on-site HIV and HCV testing services in methadone maintenance treatment programs in the United States: findings from a national multisite qualitative study.","volume":"27","author":"Behrends","year":"2021","journal-title":"J Public Health Manag Pract"},{"issue":"2","key":"zoi230438r24","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.37385","article-title":"Interventions to address the opioid crisis-modeling predictions and consequences of inaction.","volume":"4","author":"Volkow","year":"2021","journal-title":"JAMA Netw Open"},{"key":"zoi230438r6","author":"Mancher","year":"2019"},{"key":"zoi230438r7","author":"Chou","year":"2016"},{"key":"zoi230438r1","unstructured":"National Institute on Drug Abuse. Drug Overdose Death Rates. National Institute on Drug Abuse. Published February 9, 2023. Accessed February 24, 2023. https:\/\/nida.nih.gov\/research-topics\/trends-statistics\/overdose-death-rates"},{"key":"zoi230438r11","unstructured":"US Department of Health and Human Services Office of Inspector General. Many Medicare Beneficiaries Are Not Receiving Medication to Treat Their Opioid Use Disorder. Accessed November 22, 2022. https:\/\/oig.hhs.gov\/oei\/reports\/OEI-02-20-00390.asp"},{"key":"zoi230438r12","unstructured":"Cubanski? J, Neuman? T. What to Know about Medicare Spending and Financing. Kaiser Family Foundation. Published 2023. Accessed March 6, 2023. https:\/\/www.kff.org\/medicare\/issue-brief\/what-to-know-about-medicare-spending-and-financing\/"},{"key":"zoi230438r13","unstructured":"Center for Medicare & Medicaid Services. Opioid Treatment Programs. Published 2021. Accessed February 24, 2023. https:\/\/www.cms.gov\/Center\/Provider-Type\/Opioid-Treatment-Program-Center"},{"key":"zoi230438r14","unstructured":"Center for Medicare & Medicaid Services. Frequently Asked Questions. Published 2022. Accessed February 24, 2023. https:\/\/www.cms.gov\/medicare\/medicare-fee-for-service-payment\/opioid-treatment-program"},{"key":"zoi230438r15","unstructured":"Substance Abuse and Mental Health Services Administration. SAMHSA Extends the Methadone Take-Home Flexibility for One Year While Working Toward a Permanent Solution. Published November 18, 2021. Accessed July 26, 2022. https:\/\/www.samhsa.gov\/newsroom\/press-announcements\/202111181000"},{"key":"zoi230438r18","unstructured":"Center for Medicare & Medicaid Services. Opioid Treatment Programs (OTPs) Medicare Billing & Payment. 2021. Accessed April 11, 2023. https:\/\/www.cms.gov\/files\/document\/otp-billing-and-payment-fact-sheet.pdf"},{"key":"zoi230438r19","unstructured":"National Survey of Substance Abuse Treatment Services (N-SSATS). 2016. Accessed April 11, 2023. https:\/\/Wwwdasis.Samhsa.Gov\/Dasis2\/Nssats\/NSSATS_2016\/2016_nssats_puf_codebook.pdf"},{"key":"zoi230438r23","unstructured":"Freed? M, Biniek? JF, Damico? A, Neuman? T. Medicare Advantage in 2022: Enrollment Update and Key Trends. Kaiser Family Foundation. Published 2022. Accessed March 6, 2023. https:\/\/www.kff.org\/medicare\/issue-brief\/medicare-advantage-in-2022-enrollment-update-and-key-trends\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2805031\/taylor_2023_oi_230438_1685636014.83249.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T12:15:45Z","timestamp":1702469745000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2805031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,19]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.14328","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,19]]}}}