Access to and Engagement in Substance Use Disorder Treatment over Time

Abstract

Objective: This study evaluated whether access to and engagement in substance use disorder treatment has improved from 2010 to 2016. Methods: Data submitted by commercial and Medicaid health plans, representing over 163 million beneficiaries from 2010 to 2016, were analyzed. Results: For commercial plans, identification increased (from 1.0% to 1.6%, p,0.001), the initiation rate declined (from 41.9% to 33.7%, p,0.001), and the engagement rate also declined (from 15.8% to 12.1%, p,0.001). The decline in the initiation and engagement rates could not be explained by the increasing identification rates. For Medicaid plans, the identification rate increased (from 3.3% to 6.7%, p,0.001), and the initiation and engagement rates were unchanged. Conclusions: Although an increasing proportion of health plan members are being identified with substance use disorders, the majority of these individuals are not engaging in treatment.