Pre-Release Medicaid Enrollment Assistance For Incarcerated Individuals With Addiction Increased Likelihood Of Post-Release Outpatient Visits

The availability of pre-release Medicaid enrollment assistance for inmates with addiction disorder was associated with an increase in the likelihood of any outpatient visit. The share of adults released from prison who made an outpatient visit rose from 16.1% at baseline to 24.4% during the enrollment assistance period. The share with an addiction disorder who made an outpatient visit rose from 2.5% at baseline to 3.8%. The share with an opioid use disorder who made an outpatient visit rose from 0.7% at baseline to 1.4%. The share with an opioid use disorder who received medication assisted treatment rose from 0.3% at baseline to 0.7%.

Having Medicaid enrollment assistance available before release had no impact on the likelihood of an emergency department visit or an emergency department visit for overdose. The unadjusted rate for an emergency department visit for any reason was 5.6% at baseline and 6.2% during the enrollment assistance period. The rate of emergency department visits for an overdose rose from 0.3% at baseline to 0.4% during the enrollment assistance period. However, the rise for both outcomes could have been due to chance. The percentage of those with an inpatient stay within 30 days post release rose from 0.8% to 1.1%, and the percentage with an inpatient stay for overdose rose from 0.06% to 0.2%, but the rise for both outcomes could have been due to chance.

These findings were reported in “Association Between Assistance With Medicaid Enrollment and Use of Health Care After Incarceration Among Adults With a History of Substance Use” by Marguerite E. Burns, Ph.D.; Steven Cook, MS; Lars M. Brown, MA; and colleagues. The researchers linked person-level data from several Wisconsin agencies: the Department of Corrections (DOC), the Division of Medicaid Services, the State Lab of Hygiene, and the Electronic Data Surveillance System in the Institute for Research on Poverty’s Wisconsin Administrative Data Core. The sample included 16,307 individuals with 18,265 eligible releases. The determination of addiction treatment need and self-reported opioid medication use from the DOC’s risk and needs assessment tool, the Correctional Offender Management Profiling for Alternative Sanctions (COMPAS) tool. The goal was to evaluate whether a pre-release Medicaid enrollment assistance program is associated with increased health care use within 30 days after release from prison.

The full text of “Association Between Assistance With Medicaid Enrollment and Use of Health Care After Incarceration Among Adults With a History of Substance Use” was published January 7, 2022, by JAMA Network Open. A free abstract is available online at https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787710 (accessed January 21, 2022).

OPEN MINDS last reported on this topic in “New York To Extend Medicaid Coverage To Incarcerated Individuals 30 Days Prior To Release,” which published on December 2, 2019. The article can be found at https://openminds.com/market-intelligence/news/new-york-to-extend-medicaid-coverage-to-incarcerated-individuals-30-days-prior-to-release/.

For more information, contact: Marguerite E. Burns, Ph.D., Associate Professor, Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 North Walnut Street, Room 760A, Madison, Wisconsin 53726; Email: meburns@wisc.edu; Website: https://pophealth.wisc.edu/staff/burns-marguerite/