Ensuring access to high-quality substance use disorder treatment for Medicaid enrollees: A qualitative study of diverse stakeholders’ perspectives

Racial/Ethnic Disparities in Substance Use Treatment in Medicaid Managed Care in New York City

“…31,32 These findings were highlighted in our earlier work detailing how non-English speaking patients, mostly Asians, who required residential services were limited to outpatient clinic visits because of inconsistent language supports across inpatient levels of care. 33 For treatment engagement, the presence of a small Hispanic disparity (6.3% lower for Hispanics) but not a Black-White disparity is consistent with Pinedo's analysis of the 2015-2017 National Survey on Drug Use and Health. 34 When controlling for insurance, Hispanic but not Black adults were less likely than White enrollees to use specialty treatment for substance use.…”

“…The finding for Asians and Hispanics could be partly explained by a shortage of culturally and linguistically matched services for this population 31,32. These findings were highlighted in our earlier work detailing how non-English speaking patients, mostly Asians, who required residential services were limited to outpatient clinic visits because of inconsistent language supports across inpatient levels of care 33. For treatment engagement, the presence of a small Hispanic disparity (6.3% lower for Hispanics) but not a Black-White disparity is consistent with Pinedo’s analysis of the 2015–2017 National Survey on Drug Use and Health 34.…”

“…Most Asian Americans in NYC reside in Chinatown (62%) and Flushing (68.8%), many of whom report significant limited English proficiency 40. While there are some SUD treatment centers in areas where most Asians live,41 many clinics in NYC lack the resources to adequately work with linguistic minorities and meet their specific treatment needs 33…”

Performance Metrics of Substance Use Disorder Care Among Medicaid Enrollees in New York, New York

“…14 Nonetheless, some argue that SUD treatment and outcomes in MMC will be better than fee for service given the potential for better coordination and integration. 15 New York State (NYS) operates one of the country's largest Medicaid programs, 16 which has privatized health insurance and management. 17 More than three-quarters of Medicaid beneficiaries are enrolled in MMC plans, 16 with much unknown about the associations of different approaches with access, quality, and outcomes.…”

“…14 Nonetheless, some argue that SUD treatment and outcomes in MMC will be better than fee for service given the potential for better coordination and integration. 15 …”