Treatment and Incarceration MARY KATE MOHLMAN, PHD, MS HEALTH - PowerPoint PPT Presentation

Opioid Use Disorder: Treatment and Incarceration MARY KATE MOHLMAN, PHD, MS HEALTH SERVICES RESEARCHER DEPARTMENT OF VERMONT HEALTH ACCESS

Expenditures and Inpatient Hospitalizations, Per Member Per Year 0.4 Utilization 0.35 0.3 0.25 0.2 Expenditures Including and Excluding Treatment Costs, 0.15 Unadjusted, Per Member Per Year 0.1 $25,000 0.05 0 $20,000 2011 2012 2013 2014 2015 2016 2017 Non-OUD OUD Diagnosis, MAT OUD Diagnosis, Other SUD Treatment $15,000 Emergency Department Visits Per Member Per Year 2.5 $10,000 2 $5,000 1.5 $0 1 2011 2012 2013 2014 2015 2016 2017 OUD Dx & MAT w/ Treatment Costs OUD Dx & MAT, No Treatment Costs 0.5 OUD Dx & Other SUD Tx w/ Treatment Costs OUD Dx & Other SUD Tx, No Treatment Costs 0 2011 2012 2013 2014 2015 2016 2017 OUD = Opioid Use Disorder; SUD = Substance Use Disorder Non-OUD OUD Diagnosis, MAT OUD Diagnosis, Other SUD Treatment MAT = medication-assisted treatment; Tx = Treatment

Average Number of Days Incarcerated, Per Member Per Rates of Incarceration by Year 35 Treatment Type 30 25 20 15 Percent Incarcerated During Year 10 40.00% 5 35.00% 0 2011 2012 2013 2014 2015 2016 2017 30.00% Non-OUD OUD Diagnosis, MAT OUD Diagnosis, Other SUD Treatment 25.00% 20.00% Average Episodes of Incareration, Per Member Per Year 15.00% 0.8 10.00% 0.6 5.00% 0.4 0.00% 2011 2012 2013 2014 2015 2016 2017 0.2 Non-OUD OUD Dianosis, MAT OUD Diagnosis, Other SUD Treatment 0 2011 2012 2013 2014 2015 2016 2017 OUD = Opioid Use Disorder SUD = Substance Use Disorder Non-OUD OUD Diagnosis, MAT OUD Diagnosis, Other SUD Treatment MAT = medication-assisted treatment

Vermont’s All -Payer Claims Database • Medicaid members age 18-64 • Including Dually-Eligible Evaluation: • Opioid Use Disorder diagnosis • 2 diagnoses on separate occasions over the past 24 months. Data Sources • Stratification by treatment • Medication-assisted treatment (MAT), including psycho-social and supports • Other non-MAT forms of substance use disorder treatment Methodology Vermont’s Department of Corrections Offender Management System • Linked to APCD data, • Used jacket and booking numbers to follow individuals and incarceration episodes, respectively • Reviewed incarceration episodes only, not community supervision