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Opioid Use Disorder Treatment for Dual Medicare and Medicaid Patients

Award Number: R21DA066004
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 05/01/2026
PERIOD OF PERFORMANCE END DATE: 04/30/2028

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Opioid Use Disorder Treatment for Dual Medicare and Medicaid Patients - 7. PROJECT SUMMARY/ABSTRACT Individuals dually enrolled in Medicaid and Medicare (hereafter: “dual enrollees)” have high rates of untreated opioid use disorder (OUD), which is associated with repeated visits to the emergency department, inpatient hospitalizations, and ultimately risk of overdose death. Medication for OUD (MOUD) significantly reduces overdose and other associated risks of OUD (fractures, etc.). National access to MOUD is low, including for dual enrollees. For them, the lack of integration between Medicaid and Medicare and patient social determinants associated with poor health status may present additional barriers to MOUD access. Dual special needs plans (D-SNPs) were created to improve outcomes for dual enrollees. These plans could address the above-referenced barriers to MOUD through integrated Medicare and Medicaid benefits and coverage, and through supplemental wrap-around service benefits addressing social determinants. However, MOUD access and OUD-related healthcare utilization have not been examined in D-SNPs. The proposed study uses MA utilization and prescription claims and enrollment data (2021-2024) and D-SNP plan benefit package data to determine (Aim 1) whether D-SNP enrollment is associated with better utilization outcomes, mediated by treatment outcomes, and (Aim 2) the degree to which D-SNP heterogeneity in integration and supplemental wrap-around service benefits moderate these relationships. In Aim 1, we will apply a propensity score weighting algorithm and an instrumental variable approach to address potentially biasing voluntary D-SNP enrollment. The treatment outcomes use a National Quality Forum (NQF) process measure of MOUD (buprenorphine, methadone, and extended-release naltrexone) retention (#3175). The utilization outcomes are emergency department visits and inpatient stays. Using structural equation modeling, we will estimate the direct and indirect associations between D-SNPs and utilization outcomes, potentially mediated by treatment. In Aim 2, we will test moderators of the relationships in Aim 1, where the moderators be created using detailed plan benefit data indicating integration level, and benefits for health-related and non-health-related meals, medical and non-medical transportation, and other wrap-around services to characterize heterogeneity across D-SNPs in the ways that the plans address social determinants of health. The findings will determine whether and how D-SNPs serve dual enrollees with OUD. Findings can inform future refinements of D-SNP policy, the primary approach to Medicare/Medicaid integration, optimizing it for dual enrollees. Future research can inform refinements of MA policy, affecting half of all Medicare enrollees.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $402,205 )
2026	2026	BOARD OF REGENTS OF NEVADA SYSTEM OF HIGHER EDUCATION	1664 N VIRGINIA ST	RENO	NV	89557	WASHOE	USA	Drug Use and Addiction Research Programs	000	1	4/30/2026	NEW	$402,205
														Subtotal = $402,205

Grand Total All Awards = $402,205

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Opioid Use Disorder Treatment for Dual Medicare and Medicaid Patients

Award Number: R21DA066004

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 05/01/2026

PERIOD OF PERFORMANCE END DATE: 04/30/2028

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