Assesses adults and adolescents 13 years of age and older with a new episode of alcohol or other drug (AOD) dependence who received the following:
- Initiation of AOD Treatment: Adolescents and adults who initiated treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization, telehealth or medication-assisted treatment (MAT) within 14 days of diagnosis.
- Engagement of AOD Treatment: Adolescents and adults who initiated treatment and had two or more additional AOD services or MAT within 34 days of the initiation visit.
Why It Matters
In 2016, 20.1 million Americans over 12 years of age (about 7.5% of the population) were classified as having a substance use disorder involving AOD.1 Treatment, including MAT, in conjunction with counseling or other behavioral therapies, has been shown to reduce AOD-associated morbidity and mortality, improve health, productivity and social outcomes and reduce health care spending.2,3,4. Despite strong evidence, less than 20% of individuals with substance use disorders receive treatment.1
Results – National Results
Initiation of AOD Treatment - Alcohol Abuse or Dependence
| Measure Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2021 | 12.3 | 13.3 | 43.1 | 37.3 | 38.5 |
| 2020 | 39.1 | 38.8 | 44.2 | 37.8 | 39.2 |
| 2019 | 37.6 | 37.5 | 42.0 | § | § |
| 2018 | 36.6 | 37.5 | 41.6 | 37.9 | 39.7 |
| 2017 | 36.6 | 37.4 | 41 | 38.6 | 42.8 |
Initiation of AOD Treatment - Opioid Abuse or Dependence
| Measure Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2021 | 18.9 | 18.5 | 28.4 | 31.3 | 30 |
| 2020 | 40.0 | 38.8 | 56.3 | 31.3 | 30.8 |
| 2019 | 41.2 | 39.8 | 55.9 | § | § |
| 2018 | 40.1 | 41 | 52.5 | 31.4 | 32 |
| 2017 | 42 | 41.6 | 50.2 | 31.3 | 32.9 |
Initiation of AOD Treatment - Other Drug Abuse or Dependence
| Measure Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2021 | 34.1 | 34.6 | 42.7 | 31.1 | 28.9 |
| 2020 | 36.9 | 36.8 | 43.7 | 31.5 | 28.5 |
| 2019 | 37.1 | 37.8 | 43.1 | § | § |
| 2018 | 36.6 | 38 | 42.3 | 32 | 29 |
| 2017 | 37.1 | 38.4 | 42.4 | 32.6 | 32.3 |
Initiation of AOD Treatment (Total)
| Measure Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2021 | 34.1 | 34.6 | 44.2 | 33.1 | 32.8 |
| 2020 | 37.0 | 36.6 | 45.1 | 33.2 | 33.7 |
| 2019 | 36.0 | 36.4 | 44.0 | § | § |
| 2018 | 35.4 | 36.2 | 42.8 | 33.5 | 33.9 |
| 2017 | 36.6 | 36.7 | 42.3 | 33.9 | 36.1 |
| 2016 | 33.5 | 33.9 | 40.8 | 32.7 | 36.5 |
| 2015 | 33.3 | 34.5 | 38.2 | 32.7 | 35.2 |
| 2014 | 34.7 | 36.1 | 38.3 | 32.5 | 35.1 |
| 2013 | 37.6 | 40.3 | 38.2 | 33.7 | 37.8 |
| 2012 | 39.1 | 41.2 | 39.4 | 38.8 | 43.3 |
| 2011 | 40.2 | 40.6 | 39.2 | 41 | 47.6 |
| 2010 | 42.7 | 40.8 | 42.9 | 44.6 | 57.4 |
| 2009 | 42.7 | 46 | 45.6 | 46.2 | 57.4 |
| 2008 | 42.4 | 42.6 | 44.5 | 45.9 | 49.1 |
| 2007 | 44.5 | 46 | 45.6 | 50.3 | 56.5 |
| 2006 | 43.2 | 49 | 43.3 | 50.3 | 50 |
| 2005 | 44.5 | 45.8 | 40.7 | 50.9 | 52.3 |
| 2004 | 45.9 | — | 45.7 | 52.6 | — |
Engagement of AOD Treatment - Alcohol Abuse or Dependence
| Measure Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2021 | 12.3 | 13.3 | 11.3 | 5.1 | 5 |
| 2020 | 12.7 | 14.3 | 11.0 | 4.9 | 4.8 |
| 2019 | 12.4 | 13.7 | 11.1 | § | § |
| 2018 | 11.8 | 13.6 | 10.9 | 4.9 | 4.6 |
| 2017 | 11.8 | 13.7 | 10.6 | 4.6 | 4.3 |
Engagement of AOD Treatment - Opioid Abuse or Dependence
| Measure Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2021 | 18.9 | 18.5 | 28.4 | 8.1 | 5.2 |
| 2020 | 19.2 | 19.4 | 27.8 | 7.4 | 5.8 |
| 2019 | 19.5 | 20.0 | 28.1 | § | § |
| 2018 | 19.5 | 20.3 | 25.6 | 5.3 | 3.9 |
| 2017 | 20.1 | 21.2 | 22.2 | 4.8 | 3.8 |
Engagement of AOD Treatment - Other Drug Abuse or Dependence
| Measure Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2021 | 10.7 | 12.3 | 11.2 | 3.5 | 3 |
| 2020 | 11.7 | 13.8 | 11.2 | 3.7 | 2.8 |
| 2019 | 11.8 | 14.3 | 11.6 | § | § |
| 2018 | 12 | 13.9 | 11.7 | 3.7 | 2.6 |
| 2017 | 12.3 | 14.1 | 11.6 | 3.8 | 2.9 |
Engagement of AOD Treatment (Total)
| Measure Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2021 | 11.7 | 13 | 13.9 | 5.2 | 4.5 |
| 2020 | 12.6 | 14.0 | 14.1 | 5.1 | 4.5 |
| 2019 | 12.4 | 13.9 | 14.4 | § | § |
| 2018 | 12.2 | 13.8 | 14 | 4.5 | 3.9 |
| 2017 | 12.5 | 14.3 | 13.5 | 4.4 | 3.6 |
| 2016 | 11.3 | 12.9 | 12.5 | 3.6 | 3.4 |
| 2015 | 11.8 | 13.5 | 10.2 | 3.2 | 2.9 |
| 2014 | 12.8 | 14.2 | 11.3 | 3.3 | 3.5 |
| 2013 | 13.7 | 14.8 | 10.6 | 3.2 | 3.5 |
| 2012 | 13.6 | 14.6 | 10.8 | 3.1 | 3 |
| 2011 | 15.2 | 16 | 11.9 | 3.7 | 3.8 |
| 2010 | 15.6 | 16 | 14.2 | 3.7 | 3.8 |
| 2009 | 16.1 | 15.7 | 12.3 | 4.6 | 4.2 |
| 2008 | 16.2 | 16.2 | 12.4 | 4.3 | 9.4 |
| 2007 | 15.2 | 15.2 | 14.4 | 4.5 | 6.3 |
| 2006 | 13.8 | 16 | 11.7 | 4.5 | 7 |
| 2005 | 14.1 | 15.3 | 9.7 | 4.7 | 3.2 |
| 2004 | 15.5 | _ | 11.9 | 7.1 | _ |
§ Not available due to CMS suspension of data reporting during COVID-19 pandemic.
This State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.
Figures do not account for changes in the underlying measure that could break trending. Contact Information Products via my.ncqa.org for analysis that accounts for trend breaks.
References
- Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
- National Institute on Drug Abuse (NIDA). (2018). How effective is drug addiction treatment? https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment
- Substance Abuse and Mental Health Services Administration (SAMSHA). “Medication Assisted Treatment (MAT).” https://www.integration.samhsa.gov/clinical-practice/mat/mat-overview
- (2016). Cost effectiveness of drug treatment. Retrieved from: https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iv/6-cost-effectiveness-drug-treatment