New RTI study: more Medicaid patients received opioid use disorder treatment medications in US

RESEARCH TRIANGLE PARK, N.C. — Access to medications for opioid use disorder (OUD) increased substantially among Medicaid beneficiaries across nearly every U.S. state between 2019 and 2023, according to a new study led by independent scientific research institute RTI International.

The study, published in JAMA Network Open, analyzed data covering more than 126 million annual Medicaid enrollment records from 47 states and the District of Columbia. The research team tracked progress across the OUD “Cascade of Care,” a framework that tracks patients through stages from diagnosis to sustained treatment and outcomes.    

Analysis included: 

• Percent of patients diagnosed with OUD 
• Percent of patients receiving medications for opioid use disorder (MOUD) 
• Percent of patients continuing MOUD 
• OUD outcomes (i.e., OUD-related hospitalizations and emergency department visits) 

“The increase in individuals receiving effective treatment for opioid use disorders may have contributed to the national decline in opioid overdose deaths, which began in 2023,” said Tami Mark, Ph.D., a Distinguished Fellow at RTI and a coauthor of the study. “Prior studies show that medications for opioid use disorder can cut the risk of dying in half.”  

The researchers found that the percentage of Medicaid beneficiaries diagnosed with OUD declined from 4.2% in 2019 to 3.6% in 2023, declining in 34 states and increasing in 14 states. During the same period, the percentage of patients with OUD who received MOUD increased from 60.0% to 69.1%, increasing in 45 states and declining in three states.

The percentage of patients who continued MOUD for at least 180 days fell from 62.6% to 57.7%, declining in 29 states and increasing in 19 states. The percentage of Medicaid beneficiaries diagnosed with OUD who had an OUD-related hospitalization or emergency department visit declined from 10.9% to 10.6%, declining in 17 states and increasing in 31 states. 

“The state-level variation we observed shows that progress is not evenly distributed,” said William Dowd, Ph.D., a research economist at RTI and a coauthor of the study. “Some states made gains across multiple measures, while others struggled to keep patients engaged in treatment, highlighting opportunities to learn from approaches that appear to support longer treatment duration.” 

The study was supported by the National Institutes of Health (NIH) HEAL Initiative and used national Medicaid claims data from 2018 through 2023. The authors emphasized that future research is needed to better understand the factors driving state-level differences and to identify strategies that improve long-term treatment engagement. 

Read the full study 
 
Learn more about RTI’s behavioral health research