Access to and Engagement in Substance Use Disorder Treatment Over Time.

This study evaluated whether access to and engagement in substance use disorder treatment has improved from 2010 to 2016. Data submitted by commercial and Medicaid health plans, representing over 163 million beneficiaries from 2010 to 2016, were analyzed. For commercial plans, identification increased (from 1.0% to 1.6%, p<0.001), the initiation rate declined (from 41.9% to 33.7%, p<0.001), and the engagement rate also declined (from 15.8% to 12.1%, p<0.001). The decline in the initiation and engagement rates could not be explained by the increasing identification rates. For Medicaid plans, the identification rate increased (from 3.3% to 6.7%, p<0.001), and the initiation and engagement rates were unchanged. Although an increasing proportion of health plan members are being identified with substance use disorders, the majority of these individuals are not engaging in treatment.