In 2020, as part of the 2018 Congressional SUPPORT Act, Medicare initiated bundled payments for care delivered by opioid treatment programs (OTPs) that dispense methadone and other medications for opioid use disorder (MOUD). These payments covered MOUD, counseling, therapy, and toxicology screening, along with program management, at no cost to patients. While this policy aimed to expand access to OTPs (and thus MOUD), there is little information on the program’s impact, as research remains limited.

A recent cross sectional study in JAMA Health Forum by Carter Nakamoto, Henry J. Kaiser Professor of Health Care Policy, Haiden Huskamp, and colleagues investigates how many people were impacted by this Medicare payment program, and who they are. To do this, they studied Medicare beneficiaries receiving MOUD in OTPs versus MOUD treatment in settings outside of OTPs. The study included all Medicare patients receiving MOUD as identified in 2019-2022 claims, including those dually enrolled in both Medicare and Medicaid. 

The study revealed a rapid rise in Medicare patients utilizing OTPs after the policy change, with most OTPs billing Medicare. The study shows that these OTP patients were likely to be younger, non-White, and urban residents compared to those receiving MOUD in non-OTP settings.

While the study demonstrates increased access to OTPs for Medicare beneficiaries, it also underscores ongoing disparities in treatment utilization and signals a need in communities for further support. More research is needed to understand the long-term effects of this policy change and to address disparities in treatment access.