Patients with opioid use disorder enrolled in Medicaid were less likely to receive telehealth care after the COVID-19 pandemic, compared to patients with private insurance, according to a recent Northwestern Medicine study published in Health Services Research.
Opioid-related overdose deaths in the U.S. reached an all-time high in the last several years, with more than 100,000 related deaths reported in 2022 by the National Institute on Drug Abuse.
While the popularization of telehealth care during the COVID-19 pandemic suggested increased access to care for patients with opioid use disorder, few studies have examined care access for Medicaid patients who may experience barriers to telehealth care, said Melinda Xu, a first-year medical student and a co-author of the study.
“Telehealth has been shown to address critical barriers to accessing opioid use disorder treatment such as child and family care obligations, travel times and costs, and stigma from the general public and healthcare professionals. However, telehealth has barriers of its own such as access to high-speed broadband, a working computer and high levels of technological literacy, factors that are more likely to challenge those with lower income than those with higher income. Prior studies have focused on the use of telehealth for opioid use disorder treatment for either of these groups but not comparatively,” Xu said.
In the study, Xu analyzed electronic health data collected from January 2019 through December 2021 from patients diagnosed with opioid use disorder who had contact with the Northwestern Medicine healthcare system.
Xu found that while Medicaid patients were more likely to receive telehealth care compared to privately insured patients before the COVID-19 pandemic, Medicaid enrollees were 43.7 percent less likely than privately insured patients to receive any opioid use disorder treatment after the pandemic.
The findings suggest the rise of telehealth may widen disparities in care for Medicaid patients and underscore the need for future telehealth policies to address these gaps in opioid use disorder treatment, according to Xu.
“For example, the 2024 final rule aligning 42 CFR Part 2 with the Health Insurance Portability and Accountability Act can enhance confidentiality protections and improve care coordination for substance use disorder patients, supporting equitable telehealth access. Addressing these disparities through targeted policy interventions can improve health outcomes and ensure telehealth benefits all populations equitably,” Xu said.
Lindsey Allen, PhD, assistant professor of Emergency Medicine, was corresponding author of the study.
This work was supported by Northwestern Medicine and Northwestern’s Weinberg College of Arts and Sciences.
