Perceived Impacts of the Affordable Care Act: Perspectives of Buprenorphine Prescribers

ABSTRACT

The Affordable Care Act (ACA) has been heralded as a major policy change that is expected to transform the delivery of substance use disorder (SUD) treatment. Few studies have reported on the perceived impacts of ACA from the perspectives of SUD treatment providers, such as physicians who prescribe buprenorphine to patients with opioid use disorder. The present study describes buprenorphine prescribers’ perceptions regarding impacts of the ACA on the delivery of buprenorphine and examines whether state-level approaches to implementing ACA are associated with its perceived impacts. Data are drawn from a national sample of current buprenorphine prescribers (n = 1,174) who were surveyed by mail. On average, buprenorphine prescribers reported ambivalence regarding the impacts of the ACA, as indicated by a mean of 2.75 (SD = 0.69) on a scale that ranged from 1 (“strongly disagree”) to 5 (“strongly agree”). A multi-level mixed-effects regression model indicated that physicians practicing in states that were supportive of ACA, as indicated by adopting both the Medicaid expansion and implementing a state-based health insurance exchange, had more positive perceptions of the ACA than physicians in states that had declined both of these policies. This study suggests that state approaches to ACA may be associated with varied impacts.

KEYWORDS:

• Affordable Care Act
• buprenorphine
• health reform
• physician survey
• substance use disorder treatment delivery

Funding

This research was supported by the National Institute on Drug Abuse (NIDA Grant R33DA035641), which is within the National Institutes of Health (NIH). Our use of REDCap was supported by funding from the National Center for Research Resources and the National Center for Advancing Translational Sciences (NCATS Grant 8UL1TR000117). NIDA and NCATS had no additional role in the design of the study, data collection, data analysis, or the writing of this article. The authors are solely responsible for the content of this article, which does not represent the official views of NIDA or NIH.

Additional information

Funding

This research was supported by the National Institute on Drug Abuse (NIDA Grant R33DA035641), which is within the National Institutes of Health (NIH). Our use of REDCap was supported by funding from the National Center for Research Resources and the National Center for Advancing Translational Sciences (NCATS Grant 8UL1TR000117). NIDA and NCATS had no additional role in the design of the study, data collection, data analysis, or the writing of this article. The authors are solely responsible for the content of this article, which does not represent the official views of NIDA or NIH.