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Published Online:https://doi.org/10.1176/appi.ps.20230087

Objective:

This report aimed to assess how accountable care organizations (ACOs) addressed ongoing opioid use disorder treatment needs over time.

Methods:

Responses from the 2018 (N=308 organizations) and 2022 (N=276) National Survey of Accountable Care Organizations (response rate=55% in both years) were used to examine changes in availability of medication for opioid use disorder (MOUD) among ACOs with Medicare and Medicaid contracts.

Results:

The percentage of respondents offering at least one MOUD grew from 39% in 2018 to 52% in 2022 (p<0.01). MOUDs were more likely to be available in 2022 among ACOs with (vs. without) in-network substance use treatment facilities (80% vs. 33%, p<0.001). The percentage of 2022 respondents who reported offering MOUD was similar in states with high versus low opioid overdose mortality rates.

Conclusions:

Despite growing availability of MOUD among ACOs, nearly half reported not offering any MOUD in 2022, and the availability of MOUD did not increase with treatment need.

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