Association Between Assistance With Medicaid Enrollment and Use of Health Care After Incarceration Among Adults With a History of Substance Use

Burns, Marguerite; Cook, Steven; Brown, Lars; Dague, Laura; Tyska, Steve; Romero, Karla Hernandez; McNamara, Cici; Westergaard, Ryan P.

doi:10.1001/jamanetworkopen.2021.42688

Cited by 18 publications

(20 citation statements)

References 53 publications

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“…There is also a role for policy change in facilitating linkage to community-based care. As Burns et al 3 highlight, the 2018 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act spurred the initiation of Medicaid enrollment assistance in Wisconsin. Policy changes may be needed for new programs, such as Medicaid enrollment assistance, to be implemented at scale.…”

Section: Policy Changesmentioning

confidence: 99%

“…Federal law bars Medicaid from covering health care while someone is incarcerated, except some inpatient stays at communitybased facilities, but suspending, rather than terminating, coverage places less burden on patients after being released. 1 Wisconsin is one of a minority of states that terminate Medicaid coverage, raising questions about the generalizability of the findings of Burns et al 3 to states that suspend coverage and, consequently, can automatically reenroll a portion of patients being released. This is an area that warrants further investigation.…”

Section: Policy Changesmentioning

confidence: 99%

“…tools intended for clinical care. COMPAS (Correctional Offender Management Profiling for Alternative Sanctions), one of the tools Burns et al 3 used to identify patients with SUD, is designed for corrections case management, not clinical care. It provides inexact information for both clinical decision-making and research into SUD treatment in prison and after release.…”

mentioning

confidence: 99%

“…Such programs have been shown to have positive associations with both opioid use and health care engagement outcomes. 6 Lack of specific attention to initiating MOUD may help explain why emergency department visits for overdoses did not decrease after implementation of Medicaid enrollment assistance, an additional finding of the study by Burns et al 3 More broadly, adequate management of both mental health and SUDs while incarcerated is essential because people with decompensated mental illness or addiction can experience disorganization and other behavioral symptoms that are barriers to attending followup care.…”

mentioning

confidence: 99%

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Medicaid Enrollment Assistance for People Released From Prison—One Step on a Long Road

Jack

2022

JAMA Netw Open

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More than 1.2 million people, disproportionately racial and ethnic minority individuals, are incarcerated in US prisons. More people are being released from prisons and jails because of the risk of COVID-19 1 alongside calls for decarceration from the Black Lives Matter movement. Given the dramatically increased risk of death immediately after release, primarily from opioid overdose, 2 there is an urgent need to understand how to best support the growing population of released individuals in the transition to community-based health care.Burns and colleagues 3 address this prison-to-community transition. They examine the association between Medicaid enrollment assistance prior to release and health care use in the 30 days after release from prison among people in Wisconsin with probable substance use disorder (SUD). Using a retrospective cohort design, the authors compare Medicaid-reimbursed health care between people released prior to and those released after the Wisconsin Department of Corrections implemented prerelease Medicaid enrollment assistance. They found that people who had Medicaid enrollment assistance were more likely to attend any outpatient visit, opioid use disorder (OUD) visit, and general SUD visit or to have an inpatient hospitalization within 30 days of release. They saw no difference in use of the emergency department. Overall access to care, however, remained low, particularly for SUD services. Among those released after the implementation of enrollment assistance, only 24.4% attended any outpatient visit, 3.8% attended an SUD-associated visit, and 0.7% received medication for OUD (MOUD), such as buprenorphine or methadone. This timely and well-designed study from Burns et al 3 shows us that Medicaid enrollment assistance may be necessary, but is not sufficient, for supporting people releasing from prison to link with community-based health care services. Further work is needed to develop and scale interventions that facilitate access to community care and examine whether access improves health outcomes and reduces postrelease mortality. As Burns et al 3 have done with their focus on health

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Section: Policy Changesmentioning

confidence: 99%

Section: Policy Changesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Medicaid Enrollment Assistance for People Released From Prison—One Step on a Long Road

Jack

2022

JAMA Netw Open

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“…In recognition of these issues, improving reentry outcomes has become a key priority in recent years. The key to reducing recidivism rates is to understand the nuances of reentry and deliver appropriate quality reentry programs and services (Burns et al, 2022;Mellow & Christian, 2008;Visher & Travis, 2003) that keep FIPs motivated to take advantage of assistance and thereby enhance their capacity to reintegrate successfully into their communities.…”

Section: Introductionmentioning

confidence: 99%

Accessing Behavioral Health Services and the Justice-Involved: The Significance of Ecological Considerations

Ojha

Petra

Burek

et al. 2023

JoFSW

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Knowledge and understanding of reentry challenges, reentry programming, and reentry evaluations is primarily limited to formerly incarcerated persons (FIPs) who return to urban areas despite the structural and contextual differences between urban and non-urban locales. These differences may be especially salient when it comes to access to services for behavioral health needs that, if left untreated, increase the likelihood of recidivism. Reentry planning prior to release has been found to be beneficial, as well as providing direct linkages to services post-release. However, barriers or competing priorities may keep FIPs from accessing needed behavioral health services after release. To increase the probability for more successful post-release transitions, studies need to determine and understand soon-to-be-released inmates’ likelihood of utilizing these services. Thus, the purpose of this research was to examine the importance of demographic characteristics, ecological factors, and utilization of treatment services for drugs, alcohol, mental health, and anger management prior to release to FIPs’ intent to receive these services after their release. Data was collected from 173 individuals incarcerated in either a prison or a community-based correctional facility (CBCF) and analyzed via logistic regressions. Results suggest that being female and utilization of services while incarcerated predicted intent to use drug and mental health services after release; not surprisingly, crime type and type of facility was predictive of intent to utilize anger management services post release; type of facility, and interaction of housing and concentrated disadvantage was predictive of intent to take advantage of alcohol treatment services. These findings have micro, mezzo, and macro implications and are especially relevant given the limitations of resource availability and accessibility in urban and non-urban areas. Streamlining these services to FIPs’ needs and building community capacity to meet specific needs identified by FIPs is more likely to engage them and increase their likelihood to improve reentry outcomes.

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Access to Care and Outcomes With the Affordable Care Act for Persons With Criminal Legal Involvement

Jolin,

Barsky,

Wade

et al. 2024

JAMA Health Forum

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ImportanceBy expanding health insurance to millions of people in the US, the Patient Protection and Affordable Care Act (ACA) may have important health, economic, and social welfare implications for people with criminal legal involvement—a population with disproportionately high morbidity and mortality rates.ObjectiveTo scope the literature for studies assessing the association of any provision of the ACA with 5 types of outcomes, including insurance coverage rates, access to care, health outcomes, costs of care, and social welfare outcomes among people with criminal legal involvement.Evidence ReviewThe literature search included results from PubMed, CINAHL Complete, APA Psycinfo, Embase, Social Science Database, and Web of Science and was conducted to include articles from January 1, 2014, through December 31, 2023. Only original empirical studies were included, but there were no restrictions on study design.FindingsOf the 3538 studies initially identified for potential inclusion, the final sample included 19 studies. These 19 studies differed substantially in their definition of criminal legal involvement and units of analysis. The studies also varied with respect to study design, but difference-in-differences methods were used in 10 of the included studies. With respect to outcomes, 100 unique outcomes were identified across the 19 studies, with at least 1 in all 5 outcome categories determined prior to the literature search. Health insurance coverage and access to care were the most frequently studied outcomes. Results for the other 3 outcome categories were mixed, potentially due to heterogeneous definitions of populations, interventions, and outcomes and to limitations in the availability of individual-level datasets that link incarceration data with health-related data.Conclusions and RelevanceIn this scoping review, the ACA was associated with an increase in insurance coverage and a decrease in recidivism rates among people with criminal legal involvement. Future research and data collection are needed to understand more fully health and nonhealth outcomes among people with criminal legal involvement related to the ACA and other health insurance policies—as well as the mechanisms underlying these relationships.

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Association Between Assistance With Medicaid Enrollment and Use of Health Care After Incarceration Among Adults With a History of Substance Use

Cited by 18 publications

References 53 publications

Medicaid Enrollment Assistance for People Released From Prison—One Step on a Long Road

Medicaid Enrollment Assistance for People Released From Prison—One Step on a Long Road

Accessing Behavioral Health Services and the Justice-Involved: The Significance of Ecological Considerations

Access to Care and Outcomes With the Affordable Care Act for Persons With Criminal Legal Involvement

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