Insights
Low MOUD Use Among Medicare Beneficiaries Signals Missed Opportunities for Care
As researchers focused on substance use disorder in the Medicare population, we have followed a series of data briefs produced by the Office of the Inspector General that have assembled data on the use of medications to treat opioid use disorder (MOUDs) in Medicare. Their most recent report, published in April 2025, indicates that use of MOUDs among Medicare beneficiaries remains low. In 2024, less than 20% of the Medicare population with an opioid use disorder (OUD) received an MOUD.
Elsewhere, data shows that from 2022 to 2023 adults aged 65 years or older had the largest increase in drug overdose rates of any age group. Additionally, we published a study in 2023 that estimated that Medicare spends an excess of almost $16 billion annually among beneficiaries with OUD who do not receive MOUDs. Recent data on treatment quality for Medicare beneficiaries highlight low rates across several nationally endorsed, process-based quality measures.
VIT-OUD Demonstration Shows Promising Reductions in Hospital Use and Costs
The Center for Medicare and Medicaid Innovation implemented a 4-year demonstration program called the Value in Opioid Use Disorder Treatment (VIT-OUD) Demonstration. The goal of this demonstration, as stated in its authorizing Congressional legislation, was to “increase access of applicable beneficiaries to opioid use disorder treatment services.”
Preliminary findings produced by RTI International for the first report on the VIT-OUD Demonstration were promising:
● The VIT-OUD Demonstration was associated with fewer hospitalizations and emergency department (ED) visits.
● Medicare expenditures were also lower, a reflection of lower hospitalization and ED visit rates.
These findings show that the VIT-OUD Demonstration was associated with improvements in important clinical and economic outcomes. Hospitalizations, ED visits, and Medicare expenditures were all lower among VIT-OUD beneficiary enrollees than a matched comparison group. Considering the high mortality and morbidity rates associated with OUD, and the challenges of engaging patients in high-quality treatment, these findings are promising.
For more information on the VIT-OUD Demonstration and to read the full Intermediate Report to Congress.
Learn more about RTI’s work around substance use research treatment.
Disclaimer: This piece was written by William J. Parish (Health Economist) and Tami Mark (Distinguished Fellow, Behavioral Health Financing and Quality Measurement) to share perspectives on a topic of interest. Expression of opinions within are those of the author or authors.