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May 15, 2018

Fighting the Opioid Crisis with Virginia’s Medicaid Program

More than 1,200 people in Virginia died from an opioid overdose in 2017, and hundreds more from other drug overdoses.  These alarming numbers are part of a national trend that has seen significant increases in opioid related deaths. To help deal with this crisis, Virginia launched a new program last year called Addiction and Recovery Treatment Services (ARTS). A little over a year into implementation, ARTS is already receiving national recognition for increasing treatment and reducing emergency room visits for people with substance use disorders (SUD).

Virginia is on the verge of taking the next big step forward in curbing the crisis, but only if lawmakers expand Medicaid. That’s because ARTS is administered through the state’s Medicaid program, and the only people with access are people already enrolled in Medicaid, Virginia’s children’s health programs (FAMIS and FAMIS MOMS), or the Governor’s Access Program for certain low-income people with serious mental illness.

By expanding eligibility for Medicaid, the state can increase access to care for hundreds of thousands of Virginians and ramp up the fight against the opioid crisis.

Virginia’s ARTS program was implemented in April 2017 and provides a full continuum of evidenced-based treatment services. This includes early intervention, inpatient detox, intensive outpatient programs, and peer support. As early as January 2018, the Department of Medical Assistance Services reported a 34 percent reduction in opioid prescribing and spending, a 40 percent increase in members receiving addiction treatment, and a 31 percent decrease in emergency room visits related to SUD. And since implementation, the number of Medicaid providers for addiction treatment has increased significantly.  

Prior to the implementation of the ARTS program, between 2015 and 2017, opioid- and heroin-related visits to Virginia’s emergency departments increased by 25 percent.

For locality-specific information, go to the live map by clicking here.

Effective treatment for SUD is critical for everyone in the commonwealth. Nationally, 1 in 5 nonelderly adults with an opioid addiction do not have health insurance. And when patients are unable to pay for medical care, hospitals absorb much of the cost, which can put significant pressure on hospital finances. The financial challenges of a hospital may become the financial challenges of employees and communities if a hospital closes.

By expanding Medicaid, people with incomes up to 138 percent of the poverty line ($16,753 for a single person or $28,676 for a family of three in 2018) will gain health insurance and access to treatment in the ARTS program. Throughout the state, around 102,000 individuals in Virginia with SUD or mental illness could become eligible for Medicaid coverage under expansion.

And the benefits will go beyond these individuals – hospitals will feel less financial pressure, and so will state and local budgets. In addition to the estimated savings to the state of $371 million dollars from Medicaid expansion included in the House budget proposal, the state and localities will likely save on public safety expenses. The Joint Legislative Audit & Review Commission estimated that substance abuse cost Virginia state and local governments $586 million in public safety related expenses in FY 2006 alone. That was 10 years before the opioid addiction crisis was declared a public health emergency in Virginia.

While the ARTS program has caught the nation’s eye, the nation is also watching to see whether or not Virginia will expand its Medicaid program. In doing so, Virginia can better address the opioid crisis. Supporting those with mental health issues and substance use disorder will have a positive ripple effect on Virginia’s families and communities. Medicaid expansion is good for fighting the opioid crisis and good for the commonwealth.

Health Care

Sherri Egerton

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