DOI: 10.1111/1475-6773.70172 ISSN: 0017-9124

Are Increased Engagements With Recovery Support Services Associated With Reductions in Medicaid Billing Charges and Reimbursements?

Rex W. Sitti, Brady P. Horn, Tyler Kincaid, Xiaoya Wu, Margaret Greenwood‐Ericksen, Ana P. Milan Hinostroza, Caroline Bonham

ABSTRACT

Objective

To investigate the association between recovery support services (peer and community support services) and Medicaid claims.

Study Setting and Design

This is an observational study. We estimated multivariate models with Medicaid billing charges and Medicaid reimbursements as the primary outcome and the yearly number of peer and community support encounters as the variables of interest.

Data Sources and Analytical Samples

We obtained New Mexico Medicaid claims data for 3094 individuals aged 18 years and older who received recovery support services for substance use disorder (SUD) treatment between 2018 and 2021.

Principal Findings

An additional community support worker encounter was associated with decreases of $278.42 ( p  < 0.01) in annual Medicaid billing charges and $89.69 ( p  < 0.01) in annual reimbursements. Results are robust across different types of substance use disorders, different types of charges, and a variety of functional forms. We found less consistent evidence for the association between peer support workers and Medicaid claims. Point estimates were statistically significant for the association between encounters with peer support workers and billing charges ($119.01; p  < 0.05), but not for reimbursements. Larger and more precisely estimated effects were found for the association between encounters with peer support workers and Medicaid claims for individuals with alcohol use disorder and for inpatient services.

Conclusion

These results suggest that increased engagement with community support workers for substance use disorder is associated with reductions in Medicaid billing charges and reimbursements for other services.

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