{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:34:52Z","timestamp":1780079692580,"version":"3.54.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T00:00:00Z","timestamp":1666051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["HHSH250201300025I"],"award-info":[{"award-number":["HHSH250201300025I"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01 DA048176"],"award-info":[{"award-number":["R01 DA048176"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["T32 HS000084"],"award-info":[{"award-number":["T32 HS000084"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>This nationwide study builds on prior research, which suggests that Federally Qualified Health Centers (FQHCs) and other primary care providers are associated with increased access to opioid use disorder (OUD) treatment. We compare health care utilization, spending, and quality for Medicaid patients diagnosed with OUD who receive primary care at FQHCs and Medicaid patients who receive most primary care in other settings, such as physician offices (non-FQHCs). We hypothesized that the integrated care model of FQHCs would be associated with greater access to medication for opioid use disorder (MOUD) and\/or behavioral health therapy and lower rates of potentially inappropriate co-prescribing.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This cross-sectional study examined 2012 Medicaid Analytic eXtract files for patients diagnosed with OUD receiving most (&gt;50%) primary care at FQHCs (N = 37,142) versus non-FQHCs (N = 196,712) in all 50 states and Washington DC. We used propensity score overlap weighting to adjust for measurable confounding between patients who received care at FQHCs versus non-FQHCs and increase generalizability of findings given variation in Medicaid programs and substance use policies across states.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>FQHC patients displayed higher primary care utilization and fee-for-service spending, and similar or lower utilization and fee-for-service spending for other health service categories. Contrary to our hypotheses, non-FQHC patients were more likely to receive timely (\u226490 days) MOUD (buprenorphine, methadone, naltrexone, or suboxone) (Relative Risk [RR] = 1.10, 95% CI: 1.07, 1.12) and more likely be retained in medication treatment (&gt;180 days) (RR = 1.12, 95% CI: 1.09, 1.14). However, non-FQHC patients were less likely to receive behavioral health therapy (mental health or substance use therapy) (RR = 0.90, 95% CI: 0.88, 0.92) and less likely to remain in behavioral health treatment (RR = 0.92, 95% CI: 0.89, 0.94). Non-FQHC patients were more likely to fill potentially inappropriate prescriptions of benzodiazepines and opioids after OUD diagnosis (RR = 1.35, 95% CI: 1.30, 1.40).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Observed patterns suggest that Medicaid patients diagnosed with OUD who obtained primary care at FQHCs received more integrated care compared to non-FQHC patients. Greater care integration may be associated with increased access to behavioral health therapy and quality of care (lower potentially inappropriate co-prescribing) but not necessarily greater access to MOUD.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0276066","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T17:37:20Z","timestamp":1666114640000},"page":"e0276066","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Health care use and spending for Medicaid patients diagnosed with opioid use disorder receiving primary care in Federally Qualified Health Centers and other primary care settings"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6625-4973","authenticated-orcid":true,"given":"Lauren","family":"Peterson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoradhan","family":"Murugesan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Nocon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hank","family":"Hoang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Bolton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Laiteerapong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold","family":"Pollack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6289-4474","authenticated-orcid":true,"given":"Jeanne","family":"Marsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,18]]},"reference":[{"key":"pone.0276066.ref001","author":"Centers for Disease Control and Prevention","year":"2021","journal-title":"Opioid Basics: Understanding the Epidemic: Centers for Disease Control and Prevention"},{"key":"pone.0276066.ref002","volume-title":"The Opioid Epidemic and Medicaid\u2019s Role in Facilitating Access to Treatment","author":"K Orgera","year":"2019"},{"key":"pone.0276066.ref003","author":"Substance Abuse and Mental Health Services Administration","year":"2021","journal-title":"Medication-Assisted Treatment (MAT)"},{"issue":"2","key":"pone.0276066.ref004","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1001\/jama.2021.7374","article-title":"Use of Medications for Treatment of Opioid Use Disorder Among US Medicaid Enrollees in 11 States, 2014\u20132018","volume":"326","year":"2021","journal-title":"JAMA"},{"issue":"1","key":"pone.0276066.ref005","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s13722-019-0160-6","article-title":"Medicaid expansion and treatment for opioid use disorders in Oregon: an interrupted time-series analysis","volume":"14","author":"D McCarty","year":"2019","journal-title":"Addiction science & clinical practice"},{"issue":"6","key":"pone.0276066.ref006","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1007\/s11606-019-04943-6","article-title":"The role of primary care in improving access to medication-assisted treatment for rural Medicaid enrollees with opioid use disorder","volume":"34","author":"ES Cole","year":"2019","journal-title":"Journal of General Internal Medicine"},{"issue":"4","key":"pone.0276066.ref007","doi-asserted-by":"crossref","first-page":"268","DOI":"10.7326\/M16-2149","article-title":"Primary care\u2013based models for the treatment of opioid use disorder: A scoping review","volume":"166","author":"PT Korthuis","year":"2017","journal-title":"Annals of internal medicine"},{"issue":"10","key":"pone.0276066.ref008","doi-asserted-by":"crossref","first-page":"e0186315","DOI":"10.1371\/journal.pone.0186315","article-title":"Primary care models for treating opioid use disorders: what actually works? 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