Seniors get poor treatment for opioid use disorder: Study
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More than 60% of Medicare enrollees with opioid use disorder are getting substandard care, according to a new study in Health Affairs.
Why it matters: Opioid use is a growing health problem for older adults in the U.S.
- Drug overdose deaths for people age 65 and older increased 11.4% between 2022 and 2023, per Centers for Disease Control and Prevention data — the largest increase of any age group that year.
The big picture: Fewer than 40% of Medicare beneficiaries with diagnosed opioid use disorder in 2020 received treatment that met the eight nationally recognized quality standards for the care, the study found.
- The findings show that Medicare needs to routinely monitor the quality of opioid use treatment it covers for seniors, researchers said.
- The study echoes federal findings from last year that found just 4% of traditional Medicare enrollees who survived drug overdoses got medication-assisted treatment for opioids like methadone or buprenorphine.
What they did: The researchers examined Medicare enrollment, claims and encounter data from 2020 and 2019, the most recent year available at the time of the study, to see whether the care provided to beneficiaries with opioid use disorder aligned with quality metrics.
- The metrics included opioid use disorder treatment initiation within two weeks of diagnosis, follow-ups at specific intervals after emergency department visits and hospitalizations, and use of pharmacotherapy to treat the condition.
By the numbers: Almost 30% of Medicare enrollees were started on treatment within 14 days of diagnosis. But just 11% met the standards for treatment engagement, which the researchers defined as getting two or more additional opioid treatment services or medications within 34 days of their first visit.
The intrigue: Medicare Advantage plans were significantly worse at meeting six out of the eight quality measures compared with traditional Medicare, the study found.
- The Biden administration in 2024 proposed adding initiation and engagement in opioid use disorder treatment as a metric for the quality ratings it gives privately run Medicare plans. But the Trump administration has not finalized the change.
