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Medicaid Behavioral Health

An Evaluation of Whether Medical Savings are Associated with Expanding Opioid Maintenance Therapy for Heroin Addiction in Baltimore City, August 28, 2007

This is the final report in a series exploring whether the expansion of buprenorphine as a strategy for battling opioid (e.g., heroin) addiction is cost-effective, and is a summary and synthesis of the four previous reports regarding methadone and buprenorphine treatments for opioid dependence. This study considers the medical expenditures (through Medicaid) correlated to heroin treatment in Baltimore City so that such estimates may be used to determine the impact of expanding buprenorphine. Buprenorphine was not studied directly, except via a secondary source literature review, because the therapy is not yet widely prescribed in Medicaid. Overall, the four reports indicate that expanding opioid maintenance therapy (OMT) does have the potential to save the publicly financed health care system money by reducing heroin-associated morbidity in Medicaid and other insured and uninsured populations. The report also estimates that Baltimore City could save over $4,000,000.00 per year if utilization of OMT were expanded.

Comparing Pre-Treatment to Post-Treatment Medicaid Utilization in Individuals who Enter Methadone Therapy, August 15, 2007

This report is the fourth in the series about the medical costs and benefits associated with expanding buprenorphine treatment as a therapy for heroin addiction. The report looks at the utilization of Medicaid services by individuals with opioid dependence before and after they initiate opioid maintenance treatment (OMT). In addition, the study compares utilization of these individuals treated in Baltimore City with those treated in the rest of the state. The study's results support the value and effectiveness of methadone treatment, both clinically and financially, and suggest that expanding treatment access has the potential to reduce both individual suffering and overall societal burden associated with opioid dependence without increasing the cost of medical care.

Opioid Exposure in Maryland Hospitals, July 2007

This report, the third in a series commissioned by the Baltimore City Health Department, examines service utilization and comorbidities associated with opioid dependence in Maryland hospitals. The analysis used Maryland Medicaid data and hospital data provided by the Maryland Health Services Cost Review Commission.

Review of Cost-Benefit and Cost-Effectiveness Literature for Methadone or Buprenorphine as a Treatment for Opiate Addiction, August 29, 2007

This is the second in a series of reports prepared by The Hilltop Institute (as the Center for Health Program Development and Management) on behalf of the Baltimore City Health Department to assist them in the evaluation of buprenorphine as a therapy for opioid addiction. This report reviewed the literature on cost-benefits and cost-effectiveness of the use of methadone or buprenorphine for opiate addiction treatment. Support for this work comes from the Annie E. Casey Foundation.

Heroin Addiction Treatment Correlates in Maryland, March 12, 2007

This is the first report in a series commissioned by the Baltimore City Health Department exploring whether the expansion of buprenorphine as a strategy for battling opioid addiction is cost-effective. This report uses Medicaid data to examine health care service utilization differences between opioid addicts who were treated for this condition versus addicts who were not. Click here to see the article on the report in The Baltimore Sun.