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Principal Investigator: Andrew James Barnes
Organization: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
Fiscal Year: 2024
Award: $2,307,901
Funding agency: National Institute on Drug Abuse
Project Summary
Medicaid covers the majority of individuals who need opioid use disorder (OUD) treatment and
disproportionately covers minoritized populations and those with socioeconomic risk factors. Improving OUD
treatment quality in Medicaid thus can reach large numbers and inform efforts to redress inequities in care.
State Medicaid programs have changed policy to expand the continuum of care, remove barriers to treatment,
and improve the quality of OUD care. However, states have taken these actions amidst OUD quality
measurement systems that are underdeveloped limiting opportunities for targeted intervention and robust
evaluation of policy effects. Current OUD quality measures are limited in three key ways. First, OUD quality
measures are seldom constructed at the provider-level, despite the fact that clinicians, practices, and facilities
are the most likely locus of intervention for quality improvement programs. Second, few measures incorporate
OUD patient-reported outcomes or experiences of care. Third, quality measures are typically not reported by
population sub-group and thus fail to identify inequities in treatment based on race and ethnicity amenable to
policy and programmatic changes.
The Medicaid Outcomes Distributed Research Network (MODRN) has supported Medicaid agency efforts to
improve OUD treatment by developing novel measures of treatment quality and examining effects of treatment
quality on overdose. MODRN will develop Equity and QUality Improvement for Medicaid Programs
(EQUIP) and draw on our robust university-state partnerships in 12 states accounting for 24% of the US
Medicaid population. Our overarching goal is to develop OUD quality measures that can be constructed at the
provider-level, incorporate patient experience, and center health equity. Efficient and sustainable OUD quality
measures developed and implemented by MODRN-EQUIP will guide quality improvement initiatives and
Medicaid policy decisions. Our goal will be achieved through three integrated research projects aiming to: 1)
develop provider-level OUD quality measures using Medicaid administrative data; 2) measure OUD patient-
reported outcomes and examine associations with claims-based quality measures to guide quality and equity
improvement, and 3) implement and examine the effectiveness of a practice-level quality improvement
intervention for OUD.
A State Steering Committee of Medicaid leaders will oversee MODRN-EQUIP, drawing on infrastructure
supported by prior NIDA grants (R01DA055585 and R01DA048029). These research projects will be executed
by a Coordinating Center, a Methods Core and an Engagement and Dissemination Core that draws on the
expertise of Medicaid beneficiaries, providers, managed care organizations and policymakers to develop
quality measurement and management systems to transform substance use treatment. We will disseminate
our findings through state policy networks to reach beyond our 12 states to other Medicaid programs.
Terms: <Accounting><Active Follow-up><Caring><Case Mixes><Continuity of Care><Continuity of Patient Care><Continuum of Care><Data><Decision Making><Disparities><Disparity><Drugs><Effectiveness><Enrollment><Equity><Ethnic Origin><Ethnicity><Federally Qualified Health Center><Feedback><Freedom><Goals><Grant><Healthcare><Housing><Improve Access><Individual><Individuals from minority><Individuals of minority><Inequity><Infrastructure><Intervention><Intervention Strategies><Learning><Liberty><Managed Care><Measurement><Measures><Medicaid><Medication><Methods><Minority Groups><Minority People><Minority Population><Minority individual><Modality><Modeling><NIDA><National Institute of Drug Abuse><National Institute on Drug Abuse><Out-patients><Outcome><Outpatients><Overdose><Patient Outcomes Assessments><Patient Reported Measures><Patient Reported Outcomes><Patients><Pharmaceutical Preparations><Physicians><Policies><Policy Analyses><Policy Analysis><Policy Maker><Population><Process Measure><Provider><QOL><Quality of life><Quasi-experiment><Quasi-experimental analysis><Quasi-experimental approach><Quasi-experimental design><Quasi-experimental methods><Quasi-experimental research><Quasi-experimental study><Quasi-experimental technique><R-Series Research Projects><R01 Mechanism><R01 Program><Race><Races><Reporting><Research><Research Grants><Research Project Grants><Research Projects><Risk Factors><Sampling><Security><Subgroup><Survey Instrument><Surveys><System><Testing><Universities><Variant><Variation><active followup><assess effectiveness><barrier to care><barrier to health care><barrier to healthcare><barrier to treatment><behavioral health><beneficiary><clinician factors><clinician-level factors><comparator group><comparison group><determine effectiveness><drug/agent><effectiveness assessment><effectiveness evaluation><enroll><evaluate effectiveness><examine effectiveness><experience><experienced discrimination><follow up><follow-up><followed up><followup><health care><health equity><improved><intervention effect><interventional strategy><medication for opioid use disorder><novel><obstacle to care><obstacle to healthcare><opiate consumption><opiate drug use><opiate intake><opiate use><opiate use disorder><opioid consumption><opioid drug use><opioid intake><opioid treatment program><opioid use><opioid use disorder><participant engagement><patient engagement><perceived discrimination><perception of discrimination><physician factors><physician-level factors><policy evaluation><programs><provider factors><provider-level factors><psychosocial><racial><racial background><racial origin><residential segregation><response><self-reported discrimination><social deprivation><socio-economic><socio-economically><socioeconomically><socioeconomics><substance use treatment><treatment effect>