CHSE/Public Health paper finds Oregon’s Medicaid expansion and health care reforms enhanced access and improved treatment initiation for alcohol use disorders

09/06/18  Portland, Ore.

CHSE analyst Yifan Gu’s worked on a manuscript that examines access to treatment for alcohol use disorders following Oregon’s health care reforms and Medicaid expansion.

Yifan Gu has worked as an analyst at CHSE since 2017, and the first manuscript she worked on at CHSE was published in the Journal of Substance Abuse Treatment earlier this month. 

“It was exciting to me. The ultimate goal for each of my projects is for results to be published and shared with other people and have some impact on society or public health,” says Gu. 

The study examined impacts of delivery system reforms and Medicaid expansion on treatment for alcohol use disorders within the Oregon Health Plan, Oregon's Medicaid program. 

Gu and a team of five others, three of whom work at the center, extracted diagnoses, services, and pharmacy claims related to alcohol use disorders from Medicaid encounter data. Using different analyses, they assessed the percent of people with alcohol use disorder entering care and the percent receiving pharmacotherapy before and after the initiation of the CCO model in Oregon. Analyses also examined the changes in access to care following Medicaid expansion in 2014. 

“We were looking at how many people got the specialty care treatment, and how many people got the pharmacotherapy treatment. We hope both of them go up, we hope more people get treatment, no matter which way the providers decide, we just hope people get treatment. Both interventions take effect on the change,” says Gu. 

Gu’s favorite part of the study was working with the data and learning about the background of the study. “Before I got to this topic, I never got to touch this group of people who had alcohol use disorder or substance use disorder. I never thought about that because I don’t have anybody with substance use disorders in my family or friends. I didn’t realize that this is such a big issue for Oregon.” 

Treatment entry rates increased from 35% in 2010 to 41% in 2015 following the introduction of Oregon CCOs and Medicaid expansion. The number of Medicaid enrollees with a diagnosed alcohol use disorder increased about 150% from 10,360 enrollees in 2013 to 25,454 enrollees in 2014 following Medicaid expansion. 

The number of enrollees who were prescribed a medication to support recovery also increased, from 2.3% in 2010 to 3.8% in 2015. 

Before working on this manuscript Gu had never heard of medications used to treat alcohol use disorders. She liked learning that medication can help with substance use problems, and says the state is trying to encourage providers to combine medication with regular therapy. 

Read the paper (may require journal membership).