Impact of the COVID-19 pandemic on health care utilization for commercial and Medicaid beneficiaries with opioid use disorder

Abstract

Introduction We sought to examine how COVID-19 affected opioid use disorder (OUD)-specific health care utilization for insured individuals with preexisting OUD during the first year of the pandemic. Methods In this retrospective cohort study, using data from the Merative™ MarketScan® Commercial and Medicaid data, we examined pre- and post-pandemic changes receipt of therapy, medication for opioid use disorder (MOUD), and emergency department (ED) and inpatient admissions. Results The pandemic-exposed cohort was more likely to receive therapy; however, the commercial sample did not evidence change in the number of sessions received while Medicaid beneficiaries evidenced a significant decrease of 3.87 sessions per year, p < 0.001. We observed increases in the likelihood of receiving any MOUD among Medicaid beneficiaries, but significant decreases in months of MOUD for both commercial (2.16 months, p < 0.001) and Medicaid pandemic cohorts (1.94 months, p < 0.001) compared with their respective pre-pandemic cohorts. There were significant decreases in the likelihood of any and the count of emergency department visits across samples during the pandemic, all p < 0.001. For the Medicaid sample, there was a significant decrease in the likelihood of having an inpatient admission, p < 0.001, and there was a greater decrease in the number of inpatient days per year among commercially insured, p = 0.011 during the pandemic. Conclusions Adults diagnosed with OUD before the pandemic experienced significant disruptions to care, particularly continuity of care and access to emergency services, despite efforts by policymakers to counter pandemic-related access barriers.