The quality of opioid use disorder treatment in Medicare is low and lags behind Medicaid

Abstract

The Centers for Medicare and Medicaid Services regularly assesses the quality of opioid use disorder (OUD) treatment received by Medicaid beneficiaries. However, to date, there has been no comprehensive assessment of Medicare OUD treatment. In 2022, 1.9 million Medicare beneficiaries had OUD, and from 2022 to 2023, adults ages sixty-five and older experienced the largest increase in drug overdose of any age group. Using Medicare enrollment, claims, and encounter data, we assessed the extent to which Medicare beneficiaries with OUD received treatment in accordance with eight nationally recognized quality measures in 2020. We found that fewer than 40 percent of Medicare beneficiaries with OUD received care in alignment with OUD quality measures. Medicare Advantage performed worse than fee-for-service Medicare on six of the eight measures. Medicare performed worse than Medicaid on all three OUD quality measures available for comparison. These findings highlight the need for routine monitoring of OUD treatment quality in Medicare. Such monitoring would inform the development of policies to improve OUD treatment for Medicare beneficiaries and would provide a useful tool to use in evaluating the efficacy of such policies on an ongoing basis.