Do more opioid policies reduce opioid dispensing in traditional medicaid?: A national analysis

Abstract Background Several Medicaid programs have implemented approaches to ensure the appropriateness of opioid utilization and decrease opioid dispensing. Objective To evaluate whether Medicaid opioid harm reduction strategies (OHRS) resulted in a decrease in opioid claims, costs, or units reimbursed per beneficiary. Methods The number of OHRS was determined for each state's fee-for-service (FFS) Medicaid program according to previously published data. Publically available FFS Medicaid data were tabulated by state for opioid claims, costs, and units reimbursed in state fiscal years 2016 and 2017. Multivariable generalized estimating equation (GEE) models were utilized to analyze the data. Results GEE results indicated that OHRS intensity or change in OHRS did not impact opioid claims or units reimbursed in Medicaid FFS programs. A significant finding on reduction in beneficiary-adjusted opioid costs was observed for states with two OHRS compared to states with no OHRS. There were no significant differences in opioid claims, units reimbursed, and costs based on states with 3 or fewer OHRS versus those with four or more. When examining the differential effect of each individual type of OHRS, there were no significant differences in opioid claims, units reimbursed, nor medication costs. Conclusions The number of OHRS may not be associated with opioid dispensing or utilization in FFS Medicaid programs. Other factors may have led to the decrease in opioid claims for Medicaid.