Performance Metrics of Substance Use Disorder Care Among Medicaid Enrollees in New York, New York

Abstract

IMPORTANCEThere is limited evaluation of the performance of Medicaid managed care (MMC) private plans in covering substance use disorder (SUD) treatment.

Meeting the Needs of Medicaid Beneficiaries With Substance Use Disorders in Managed Care

“…The second strength is the use of random MCO assignment to mitigate confounding due to differences among beneficiaries in the prevalence or severity of SUD in estimates of MCO-level performance. 6 This approach takes advantage of a distinctive feature of Medicaid policy, which is the use of mandatory managed care with auto-assignment to MCOs. Nearly 25 million Medicaid enrollees are expected to be assigned to an MCO over the next decade.…”

“…7 The fraction of enrollees assigned to a MCO (because they do not make a choice or are not given a choice of plan) varies significantly from less than 10% in New York to 100% in Hawaii and Tennessee. 7 In the study by Alegría and colleagues, 6 participants were drawn from the 4% of enrollees who were randomly assigned, which may limit generalizability, as the authors acknowledge.…”