OIG Companion Product

Medicare and Medicaid Enrollees in Many High-Need Areas May Lack Access to Medications for Opioid Use Disorder

Overview

This companion product presents 13 interactive maps using 2022 county- and State-level data related to OEI’s report: Medicare and Medicaid Enrollees in Many High-Need Areas May Lack Access to Medications for Opioid Use Disorder (OEI-BL-23-00160). Opioid use disorder is a problematic pattern of opioid use that leads to clinically significant impairment or distress. It is a chronic disease that can be treated with medications for opioid use disorder (MOUD) administered or dispensed by opioid treatment programs and office-based buprenorphine providers (hereafter referred to as MOUD providers). This companion product allows readers to investigate whether these MOUD providers were treating Medicare and Medicaid enrollees in specific counties and States during calendar year 2022.

See the Table of Contents for a list of the product's maps. Either scroll or use the header links at the top of the page to navigate to each section.

County Comparisons

County map on the number of MOUD providers available
County map on the need for MOUD services and social vulnerability status
County map on the number of MOUD providers in high-need, socially vulnerable areas
County map comparing the number of MOUD providers that treated any Medicare or Medicaid enrollees
County map on the number of MOUD providers that treated Medicare enrollees in high-need, socially vulnerable areas
County map on the number of MOUD providers that treated Medicaid enrollees in high-need, socially vulnerable areas

MOUD Provider Comparisons

County map on the number of opioid treatment programs or office-based buprenorphine providers available
State map comparing the percent of opioid treatment programs or office-based buprenorphine providers that treated Medicare enrollees
State map comparing the percent of opioid treatment programs or office-based buprenorphine providers that treated Medicaid enrollees

State Highlights

State map highlighting the percent of opioid treatment programs that treated Medicare enrollees
State map highlighting the percent of office-based buprenorphine providers that treated Medicare enrollees
State map highlighting the percent of opioid treatment programs that treated Medicaid enrollees
State map highlighting the percent of office-based buprenorphine providers that treated Medicaid enrollees

Read the Full Report

County Comparisons

01 / 06

Several hundred counties nationwide had no MOUD providers

In 2022, 597 of the 3,143 U.S. counties nationwide (19 percent) did not have any office-based buprenorphine providers or opioid treatment programs (i.e., MOUD providers). An additional 660 counties (21 percent) had disproportionately few MOUD providers in comparison to other counties of a similar population size.

Click on each county for more information.

Nearly half of all counties in high need of MOUD services were also socially vulnerable

Nationwide, 1,258 counties were in high need of MOUD services as indicated by their disproportionately high drug overdose mortality rates. Of these high-need counties, 586 were also socially vulnerable and therefore at greater risk during public health emergencies, such as the opioid crisis, because of factors such as socioeconomic status and household demographic characteristics.

Click on each county for more information.

Hundreds of high-need counties had few or no MOUD providers

Despite their high drug overdose mortality rates, 330 high-need counties (26 percent) had few or no MOUD providers. Consequently, many of these counties may be unable to meet opioid use disorder treatment needs for their area. Moreover, nearly half of these counties (144 counties) were also socially vulnerable and likely need additional State and Federal support to increase the number of MOUD providers available.

Chart showing that, of the 330 high-need counties with few or no MOUD providers, 212 had “few” while 118 had “no.” Of the 212 counties with few providers, 46% were socially vulnerable. Of the 118 counties with no providers, 40% were socially vulnerable.

Click on each county for more information.

Medicare vs. Medicaid: Nearly one-third of U.S. counties did not have a single MOUD provider that treated any Medicare or Medicaid enrollees

In 2022, 32 percent of all U.S. counties and 19 percent of all high-need counties (excluding Florida) did not have any MOUD providers that treated either Medicare or Medicaid enrollees. There was substantial overlap; of counties with no MOUD providers treating Medicaid enrollees, 95 percent also had no providers treating Medicare enrollees.

Note: Florida Medicaid pharmacy claims data did not have prescriber identifiers in 2022; therefore, we excluded Florida from the Medicaid portion of our nationwide analyses.

Medicare

Nationwide, 1,147 counties (36 percent) did not have any MOUD providers that prescribed or administered buprenorphine or methadone to at least one Medicare enrollee in 2022. Another 110 counties had disproportionately few providers that treated Medicare enrollees.

Medicaid

Nationwide (excluding Florida), 1,035 counties (34 percent) did not have any MOUD providers that prescribed or administered buprenorphine or methadone to at least one Medicaid enrollee in 2022. Another 195 counties had disproportionately few providers that treated Medicaid enrollees.

Click on the legend icon on the bottom left of the map to view the legend.

Click on each county for more information.

Pull the slider to the right to see the count of Medicare MOUD providers in each county.

Pull the slider to the left to see the count of Medicaid MOUD providers in each county.

Many counties had few or no MOUD providers that treated Medicare enrollees

Hundreds of counties with few or no MOUD providers treating Medicare enrollees were also in high need of MOUD services and, therefore, may not be able to meet opioid use disorder treatment needs for Medicare enrollees. In total, 316 high-need counties (25 percent) had few or no MOUD providers serving Medicare enrollees. More than one-third of these counties (123 counties) were also socially vulnerable.

Chart showing that, of the 316 high-need counties with few or no Medicare MOUD providers, 35 had “few” while 281 had “no.” Of the 35 counties with few providers, 49% were socially vulnerable. Of the 281 counties with no providers, 38% were socially vulnerable.

Click on each county for more information.

Many counties had few or no MOUD providers that treated Medicaid enrollees

As with Medicare, a concerning number of high-need counties may not be able to meet opioid use disorder treatment needs for Medicaid enrollees. In total, 297 high-need counties (24 percent) had few or no MOUD providers serving Medicaid enrollees. More than one-third of these counties (119 counties) were also socially vulnerable.

Chart showing that, of the 297 high-need counties with few or no Medicaid MOUD providers, 51 had “few” while 246 had “no.” Of the 51 counties with few providers, 53% were socially vulnerable. Of the 246 counties with no providers, 37% were socially vulnerable.

Click on each county for more information.

MOUD Provider Comparisons

Opioid Treatment Programs (OTPs) vs. Office-Based Buprenorphine Providers (OBPs): There are far fewer counties with opioid treatment programs than those with office-based buprenorphine providers

Opioid treatment programs are the only provider type able to offer treatment with methadone. However, there are far fewer opioid treatment programs (n=1,995) than office-based buprenorphine providers (n=137,744), and they are much less widespread across the Nation. Specifically, 78 percent of counties nationwide did not have opioid treatment programs compared to only 19 percent of counties that did not have any office-based buprenorphine providers.

Click on the legend icon on the bottom left of the map to view the legend.

Click on each county for more information.

Pull the slider to the right to see the counties with zero opioid treatment programs.

Pull the slider to the left to see the counties with zero office-based buprenorphine providers.

OTPs vs. OBPs: Medicare Opioid treatment programs were much more likely to have treated Medicare enrollees than office-based buprenorphine providers, though the percentage varies by State

Nationwide, 77 percent of opioid treatment programs prescribed or administered buprenorphine or methadone to at least one Medicare enrollee in 2022. In contrast, just 28 percent of office-based buprenorphine providers prescribed or administered buprenorphine to at least one Medicare enrollee.

Chart showing that 77% of opioid treatment programs prescribed or administered buprenorphine or methadone to at least one Medicare enrollee in 2022 while 28% of office-based buprenorphine providers did.

Click on the legend icon on the bottom left of the map to view the legend.

Click on each state for more information.

Pull the slider to the right to see the percentage of opioid treatment programs that treated Medicare enrollees in each state. Pull the slider to the left to see the percentage of office-based buprenorphine providers that treated Medicare enrollees in each state.

OTPs vs. OBPs: Medicaid Opioid treatment programs were also much more likely to have treated Medicaid enrollees than office-based buprenorphine providers, with variation among States

Nationwide (excluding Florida), 77 percent of opioid treatment programs prescribed or administered buprenorphine or methadone to at least one Medicaid enrollee in 2022. In contrast, just 38 percent of office-based providers nationwide (excluding Florida) prescribed or administered buprenorphine to at least one Medicaid enrollee.

Chart showing that 77% of opioid treatment programs prescribed or administered buprenorphine or methadone to at least one Medicaid enrollee in 2022 while 38% of office-based buprenorphine providers did.

Click on the legend icon on the bottom left of the map to view the legend.

Click on each state for more information.

Pull the slider to the right to see the percentage of opioid treatment programs that treated Medicaid enrollees in each state. Pull the slider to the left to see the percentage of office-based buprenorphine providers that treated Medicaid enrollees in each state.

State Highlights

State Highlights: Percentage of opioid treatment programs that treated Medicare enrollees

National Average: 77%

Click on each scenario below for more detail. Click the X next to the scenario to return to the overview map.

Note: Wyoming does not have any opioid treatment programs.

State Highlights: Percentage of office-based buprenorphine providers that treated Medicare enrollees

National Average: 28%

Click on each scenario below for more detail. Click the X next to the scenario to return to the overview map.

Note: In all 50 States and the District of Columbia, between 19 and 45 percent of office-based buprenorphine providers treated Medicare enrollees.

State Highlights: Percentage of opioid treatment programs that treated Medicaid enrollees

National Average (excluding Florida): 77%

Click on each scenario below for more detail. Click the X next to the scenario to return to the overview map.

Note: Wyoming does not have any opioid treatment programs.

State Highlights: Percentage of office-based buprenorphine providers that treated Medicaid enrollees

National Average (excluding Florida): 38%

Click on each scenario below for more detail. Click the X next to the scenario to return to the overview map.

Note: In 49 States and the District of Columbia, between 19 and 55 percent of office-based buprenorphine providers treated Medicaid enrollees. Florida was excluded from our Medicaid analyses because of data limitations.

Read the Full Report