{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T21:38:15Z","timestamp":1789767495978,"version":"4.0.1"},"reference-count":40,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>To address the opioid use disorder (OUD) public health crisis, the ADvancing Pharmacological Treatments for OUD (ADaPT-OUD) external facilitation randomized trial was conducted in 8 intervention and 27 matched control low-performing Veterans Health Administration (VHA) facilities to increase the prescribing of medications for OUD (MOUD). Facilities were considered low-performers if they were in the bottom quartile of the facility ratio of Veterans with OUD who received MOUD. The objective of this analysis was to evaluate the healthcare expenditures of Veterans with OUD who received care in ADaPT-OUD intervention facilities compared to those receiving care in matched control facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Difference-in-differences (DID) design was used to compare the overall, outpatient, and inpatient expenditures (extracted from the VHA data warehouse) of Veterans diagnosed with OUD or receiving MOUD between the 2 groups 12\u2009months before and after the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 7348 Veterans with a diagnosis of OUD or prescribed MOUD on at least 1 encounter 12\u2009months after ADaPT-OUD intervention at all sites (92.39% male and 83.26% white) were included for analysis. ADaPT-OUD intervention did not have a substantial impact on overall healthcare costs. However, we reported 4% fewer total encounters in the intervention sites (DID, 95% confidence intervals [CI]: 0.96 [0.92-1.00]) compared to the control sites, driven by a decline in non-VA services. Notably, the outpatient psychiatric-related costs were $391 (95% CI: $49-$733) higher per Veteran within the year after the intervention sites received external facilitation compared to control sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Veterans at intervention sites with an OUD history had higher outpatient psychiatric-related costs, which could be explained by increased access to optimal mental health services at VHA. Improving access to OUD treatment at VA may lead to more coordinated and comprehensive treatment of both OUD and other associated mental health and physical comorbidities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342251336035","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T01:00:02Z","timestamp":1745888402000},"page":"901-912","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Healthcare Expenditures Associated With Implementing an External Facilitation Program to Increase the Prescribing of Medications Used for the Treatment of Opioid Use Disorder Among Veterans"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8404-741X","authenticated-orcid":false,"given":"Aryan","family":"Esmaeili","sequence":"first","affiliation":[{"name":"Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildi J.","family":"Hagedorn","sequence":"additional","affiliation":[{"name":"Center for Care Delivery &amp; Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla C.","family":"Garcia","sequence":"additional","affiliation":[{"name":"Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Bangerter","sequence":"additional","affiliation":[{"name":"Center for Care Delivery &amp; Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison M.","family":"Gustavson","sequence":"additional","affiliation":[{"name":"Center for Care Delivery &amp; Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA"},{"name":"Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie E.","family":"Kenny","sequence":"additional","affiliation":[{"name":"Center for Care Delivery &amp; Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Miller","sequence":"additional","affiliation":[{"name":"Center for Care Delivery &amp; Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA"},{"name":"Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Princess E.","family":"Ackland","sequence":"additional","affiliation":[{"name":"Center for Care Delivery &amp; Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA"},{"name":"Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A.","family":"Clothier","sequence":"additional","affiliation":[{"name":"Center for Care Delivery &amp; Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siamak","family":"Noorbaloochi","sequence":"additional","affiliation":[{"name":"Center for Care Delivery &amp; Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA"},{"name":"Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Vulnerable Veteran Innovative PACT (VIP) Initiative, Informatics, Decision-Enhancement, and Analytic Sciences Center (IDEAS), Salt Lake City Veterans Affairs Health Care System, Salt Lake City, UT, USA"},{"name":"Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7343-9458","authenticated-orcid":false,"given":"Mark","family":"Bounthavong","sequence":"additional","affiliation":[{"name":"Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, CA, USA"},{"name":"Division of Clinical Pharmacy, UCSD Skaggs School of Pharmacy &amp; Pharmaceutical Sciences, La Jolla, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"National Institute on Drug Abuse. National overdose deaths involving any opioid\u2014number among all ages by sex 1999-2022. 2024. Accessed May 14 2024. https:\/\/nida.nih.gov\/research-topics\/trends-statistics\/overdose-death-rates"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S295461"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2019.08.016"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-023-08116-4"},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","unstructured":"Gordon AJ Kenny M Dungan M et al. Are X-waiver trainings enough? Facilitators and barriers to buprenorphine prescribing after X-waiver trainings. Am J Addict. 2022;31(2):152-158. doi:https:\/\/doi.org\/10.1111\/ajad.13260","DOI":"10.1111\/ajad.13260"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-021-00259-1"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-021-00119-8"},{"key":"e_1_3_3_9_2","unstructured":"Waiver Elimination (MAT Act). Medications for substance use disorders. 2024. Accessed February 12 2025. https:\/\/www.samhsa.gov\/medications-substance-use-disorders\/waiver-elimination-mat-act"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-018-0789-7"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2217-0"},{"key":"e_1_3_3_12_2","volume-title":"Dissemination and Implementation Research in Health: Translating Science to Practice","author":"Kirchner J","year":"2018","unstructured":"Kirchner J, Waltz T, Powell B, Smith J, Proctor E. Implementation strategies. In: Brownson R, Colditz G, Proctor E. eds. Dissemination and Implementation Research in Health: Translating Science to Practice. 2nd ed. Oxford University Press; 2018.","edition":"2"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0209-1"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-018-0127-z"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-07274-7"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2020.1787299"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.37238"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-020-05199-8"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X20960455"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2013.10.006"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X20954387"},{"key":"e_1_3_3_22_2","unstructured":"The United States Department of Veterans Affairs. VHA corporate data warehouse\u2014VA. 79 FR 4377; 2014. Accessed February 12 2025. https:\/\/www.hsrd.research.va.gov\/for_researchers\/cdw.cfm"},{"key":"e_1_3_3_23_2","unstructured":"Phibbs CS Barnett PG Fan A. Research guide to the managerial cost accounting national cost extracts guidebook. VA Health Economics Resource Center; 2015. Accessed July 19 2020. https:\/\/www.herc.research.va.gov\/include\/page.asp?id=guidebook-mca-nde"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000223475.70440.07"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-024-08572-1"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.4505"},{"key":"e_1_3_3_28_2","doi-asserted-by":"crossref","unstructured":"Chan D Card D Taylor L. Is there a VA Advantage? Evidence from dually eligible veterans. American Economic Review. 2023;113(11):3003\u20133043.","DOI":"10.1257\/aer.20211638"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2022.2482"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.01227.x"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/add.16289"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1080\/00031305.2016.1154108"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001394"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.02.026"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318202aa27"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-015-3492-2"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.31141"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.45898"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-023-00482-8"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.6000\/1929-6029.2016.05.01.1"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2018.1509251"}],"container-title":["Substance Use &amp; Addiction Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251336035","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29767342251336035","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251336035","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:51:15Z","timestamp":1777600275000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29767342251336035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/29767342251336035"],"URL":"https:\/\/doi.org\/10.1177\/29767342251336035","relation":{},"ISSN":["2976-7342","2976-7350"],"issn-type":[{"value":"2976-7342","type":"print"},{"value":"2976-7350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]}}}