The DOI matches its Crossref record.
Elimination of Methadone Benefits in the Oregon Health Plan and Its Effects on Patients
Abstract
OBJECTIVES: This prospective study assessed the impacts of a policy change to Oregon's Medicaid program (Oregon Health Plan; OHP) that eliminated methadone benefits for 60 percent of active methadone patients. Recipients of OHP Standard (expanded Medicaid benefits, which were discontinued after the policy change) self-selected into two groups: those who paid for methadone after the policy change and those who terminated treatment. OHP Plus beneficiaries (traditional Medicaid) did not lose benefits. METHODS: A total of 149 patients participated in the study, and interviews were conducted at baseline (time of policy change) and one, three, and 12 months after the policy change. Patients were assessed with the Addiction Severity Index (ASI), Timeline Follow Back assessment, and chart review. RESULTS: Patients who left treatment because they were unable to pay for methadone services showed significant elevations in ASI composite scores for drug and legal problems at baseline and at two and three months after the policy change. The patients who attempted to self-pay experienced significantly more employment problems than the other two groups. The OHP Standard recipients who paid for their methadone treatment over the year were more likely to have additional resources to pay for methadone, be employed, and have stable housing. CONCLUSIONS: The elimination of methadone treatment benefits in the OHP had substantial negative impacts for patients with the greatest indicators of need.
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The finding that 43.0% of SUD service utilizations were self-pay is consistent with documented barriers to SUD treatment, including lack of insurance, inadequate coverage benefits, cash-only payment acceptance, and patients' self-pay preference due to stigma-related privacy concerns.
“our finding that 43.0% of SUD service utilizations were self-pay is consistent with documented barriers to SUD treatment, including lack of insurance,24 inadequate coverage benefits across various insurance types,24, 31-36 cash-only payment acceptance (i.e., non-acceptance of any insurance) by SUD treatment providers,36 and patients’ self-pay preference due to stigma-related privacy concerns.24”
From County-Level Variation in Substance Use Disorder Service Utilization by Insurance Payers and Self-Pay in the United States (2026) · cites this paper as [31]
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Research works printed but not linked: 9
- Dr, McCarty are affiliated with the department of public health and preventive medicine at Oregon Health and Science University, 3181 S.W. Sam Jackson Park Road
- February, 2003, April 2003
- 10.1001/jama.284.16.2093 · DOI
- 10.1177/1077558702059002003 · DOI
- 10.1016/0306-4603(89)90062-2 · DOI
- 10.1001/archpsyc.58.5.503 · DOI
- 10.1111/1540-6237.00098 · DOI
- 10.1016/0740-5472(92)90062-S · DOI
- Sobell LC, 1996, Sobell MB: Timeline Follow-Up User's Guide
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Han, B., Compton, W. M., Jones, C. M., Stimson, D. T., Barfield, E. T., Bellgowan, J. F., Hobin, J. A., & Volkow, N. D. (2026) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.26m16340
Metadata
- Authors
- Fuller, B. E., Rieckmann, T. R., McCarty, D. J., Ringor-Carty, R., & Kennard, S.
- Affiliations
- Oregon Health & Science University (US)
- Venue
- Psychiatric Services
- Published
- 2006-05
- Volume
- 57
- Issue
- 5
- Pages
- 686-691
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2052346916
- Cited by
- 12
- References
- 0
- Citations by year
- 2019: 1 · 2018: 1 · 2016: 1 · 2014: 1
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1r03da017710-01)
- National Institute on Drug Abuse (1-R03-DA017710-01, R01 DA 14688)
- Center for Substance Abuse Treatment
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- methadone maintenance treatment, Oregon Health Plan, treatment discontinuation, self-pay, opioid use disorder, addiction severity, employment, housing stability, health insurance coverage
- MeSH terms
- Eligibility Determination, Female, Financing, Personal, Follow-Up Studies, Health Policy, Humans, Insurance, Pharmaceutical Services, Male, Medicaid, Methadone, Opioid-Related Disorders, Oregon, Patient Acceptance of Health Care, Patient Dropouts, Prospective Studies, Risk-Taking, Severity of Illness Index, State Health Plans, Substance Withdrawal Syndrome, United States, Program Evaluation, Medically Uninsured, Patient Satisfaction
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