Report to Congress: T-MSIS Substance Use Disorder (SUD) Data Book, Treatment of SUD in Medicaid, 2021
Download
Associated Project
Providing Data Analytics and Data Quality Support for Medicaid and CHIP Business and Information Solutions
Prepared for:
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services, Data and Systems Group (DSG)
On October 24, 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271) (SUPPORT Act) was signed into law to address, among other issues, the pressing need for substance use disorder (SUD) treatment and prevention services, with a focus on treatment for opioid use disorder. In 2021, approximately 42.9 million people ages 12 and older in the U.S. had an illicit drug or alcohol use disorder in the past year, of whom only about 2.7 million (or 6.3 percent) received treatment.
The SUPPORT Act directs the U.S. Department of Health and Human Services to publish a report focused on Medicaid beneficiaries. This fifth annual Transformed Medicaid Statistical Information System (T-MSIS) SUD Data Book reports the number of Medicaid beneficiaries with a SUD and the services they received during calendar year 2021. The information in the SUD Data Book is derived from a research-ready version of T-MSIS data—the T-MSIS Analytic Files (TAF). The T-MSIS and TAF data contain national data on Medicaid and the Children’s Health Insurance Program (CHIP), and states continue to improve the quality and completeness of their T-MSIS submissions.
With this data, we identified 62 million Medicaid beneficiaries ages 12 and older who had full or comprehensive benefits in 2021. Of these, 4.9 million (8 percent) were treated for any SUD, and 1.8 million (3 percent) were specifically treated for an opioid use disorder. Of the five major enrollment categories assessed, the prevalence of SUD treatment is highest in the aged, blind, and disabled category (10 percent) and the expansion adult enrollment category (10 percent); and beneficiaries enrolled in Medicaid in the expansion adult category accounts for the largest proportion (45 percent) of beneficiaries treated for a SUD.
The SUPPORT Act directs the U.S. Department of Health and Human Services to publish a report focused on Medicaid beneficiaries. This fifth annual Transformed Medicaid Statistical Information System (T-MSIS) SUD Data Book reports the number of Medicaid beneficiaries with a SUD and the services they received during calendar year 2021. The information in the SUD Data Book is derived from a research-ready version of T-MSIS data—the T-MSIS Analytic Files (TAF). The T-MSIS and TAF data contain national data on Medicaid and the Children’s Health Insurance Program (CHIP), and states continue to improve the quality and completeness of their T-MSIS submissions.
With this data, we identified 62 million Medicaid beneficiaries ages 12 and older who had full or comprehensive benefits in 2021. Of these, 4.9 million (8 percent) were treated for any SUD, and 1.8 million (3 percent) were specifically treated for an opioid use disorder. Of the five major enrollment categories assessed, the prevalence of SUD treatment is highest in the aged, blind, and disabled category (10 percent) and the expansion adult enrollment category (10 percent); and beneficiaries enrolled in Medicaid in the expansion adult category accounts for the largest proportion (45 percent) of beneficiaries treated for a SUD.
More like this from Mathematica
How do you apply evidence?
Take our quick four-question survey to help us curate evidence and insights that serve you.
Take our survey