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  1. Article ; Online: Advancing health equity through medication formulary policy.

    Morgan, John W / Emmelhainz, Janetta / Bachireddy, Chethan

    The American journal of managed care

    2023  Volume 29, Issue 7, Page(s) 327–330

    Abstract: Awareness of the presence and significance of disparities in American health outcomes is growing. Equitable access to appropriate medication-pharmacoequity-is foundational to equitable health care, with medication formularies representing a key ... ...

    Abstract Awareness of the presence and significance of disparities in American health outcomes is growing. Equitable access to appropriate medication-pharmacoequity-is foundational to equitable health care, with medication formularies representing a key determinant of medication access. Critical formulary design elements include clinical criteria, prescription processes, and patient access policies. Facets of each can be refined to ensure more equitable access to medications, including avoidance of prior authorization requirements, awareness of the complex determinants of human behavior, streamlined authorization processes, and optimized costs and convenience for patients. Optimizing these factors for proven treatments of conditions disproportionately borne by vulnerable communities is especially critical in the pursuit of equitable access. For policy makers at payer and pharmacy benefit manager organizations to successfully pursue corresponding changes in formulary policy, it is critical that teams educate leadership regarding the importance of policy change, invest in comprehensive patient data, and engage community members in their efforts.
    MeSH term(s) Humans ; United States ; Health Equity ; Pharmacy ; Pharmaceutical Services ; Health Services Accessibility ; Policy ; Health Policy
    Language English
    Publishing date 2023-08-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2035781-3
    ISSN 1936-2692 ; 1088-0224 ; 1096-1860
    ISSN (online) 1936-2692
    ISSN 1088-0224 ; 1096-1860
    DOI 10.37765/ajmc.2023.89393
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  2. Article ; Online: Payer strategies to ensure access to care for individuals with opioid use disorder during COVID-19.

    Bachireddy, Chethan / Terplan, Mishka

    The American journal of managed care

    2021  Volume 27, Issue 3, Page(s) 91–92

    Abstract: As the coronavirus disease 2019 (COVID-19) pandemic threatens to worsen the opioid crisis, payers must rapidly deploy policies to ensure care for individuals with opioid use disorder. ...

    Abstract As the coronavirus disease 2019 (COVID-19) pandemic threatens to worsen the opioid crisis, payers must rapidly deploy policies to ensure care for individuals with opioid use disorder.
    MeSH term(s) Ambulatory Care/economics ; Buprenorphine/therapeutic use ; COVID-19 ; Health Services Accessibility/economics ; Humans ; Insurance, Health, Reimbursement ; Methadone/therapeutic use ; Naltrexone/therapeutic use ; Opiate Substitution Treatment/economics ; Opioid-Related Disorders/drug therapy ; Telemedicine/economics ; United States/epidemiology
    Chemical Substances Buprenorphine (40D3SCR4GZ) ; Naltrexone (5S6W795CQM) ; Methadone (UC6VBE7V1Z)
    Language English
    Publishing date 2021-03-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2035781-3
    ISSN 1936-2692 ; 1088-0224 ; 1096-1860
    ISSN (online) 1936-2692
    ISSN 1088-0224 ; 1096-1860
    DOI 10.37765/ajmc.2021.88522
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  3. Article ; Online: Medicaid and COVID-19 Vaccination-Translating Equitable Allocation Into Equitable Administration.

    Bachireddy, Chethan / Dar, Mohammad / Chen, Christopher

    JAMA health forum

    2021  Volume 2, Issue 2, Page(s) e210114

    Language English
    Publishing date 2021-02-01
    Publishing country United States
    Document type Journal Article
    ISSN 2689-0186
    ISSN (online) 2689-0186
    DOI 10.1001/jamahealthforum.2021.0114
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  4. Article ; Online: Securing the Safety Net and Protecting Public Health During a Pandemic: Medicaid's Response to COVID-19.

    Bachireddy, Chethan / Chen, Christopher / Dar, Mohammad

    JAMA

    2020  Volume 323, Issue 20, Page(s) 2009–2010

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Humans ; Insurance Coverage ; Medicaid ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Safety-net Providers ; State Government ; Telemedicine/economics ; United States
    Keywords covid19
    Language English
    Publishing date 2020-01-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2020.4272
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  5. Article ; Online: Outcomes of Emergency Department Patients With Opioid Use Disorder Utilizing a Virtual Addiction Bridge Clinic: A Case Series.

    Wills, Brandon K / Ringwood, Katy J / Davis, Theresa T / Provost, Rosellen / Bachireddy, Chethan / Wang, Jennifer / Keyser-Marcus, Lori / Moeller, F Gerard

    Journal of addiction medicine

    2023  Volume 17, Issue 6, Page(s) 729–731

    Abstract: Objectives: Within the last decade, there has been a dramatic increase in the rate of emergency department (ED) visits and death from opioid overdose. Those who present to the ED are at high risk for subsequent morbidity and mortality. Despite effective ...

    Abstract Objectives: Within the last decade, there has been a dramatic increase in the rate of emergency department (ED) visits and death from opioid overdose. Those who present to the ED are at high risk for subsequent morbidity and mortality. Despite effective treatment, many patients do not get rapidly connected to outpatient care. The aim of this investigation was to describe outpatient treatment engagement after ED discharge among patients with opioid use disorder (OUD) enrolled in a virtual Addiction Bridge Clinic (ABC).
    Methods: This was a retrospective case series describing an ED-initiated referral for rapid telehealth follow-up among patients with OUD. The primary outcome was addiction treatment engagement among those who completed the initial virtual ABC visit (engaged in ABC) vs. those who did not complete an ABC visit (Not engaged in ABC) at 1 week, 1 month, and 3 and 6 months timepoint intervals after the initial ED presentation.
    Results: Of the N = 201 patients referred to the ABC between March and December 2021, a majority were Black (71%) and male (77%). Of the 201 referrals, 85 (42%) completed an initial ABC telehealth visit. Subsequent treatment engagement was 26% at 1 week, 26% at 1 month, 22% at 3 months, and 18% at 6 months after the index ED visit.
    Conclusions: A telehealth-enabled virtual addiction bridge clinic is one potential approach to reduce barriers to rapid treatment access. Strategies are needed to improve subsequent addiction treatment engagement after a virtual addiction bridge clinic visit.
    MeSH term(s) Humans ; Male ; Retrospective Studies ; Opioid-Related Disorders ; Opiate Overdose ; Ambulatory Care ; Emergency Service, Hospital
    Language English
    Publishing date 2023-09-20
    Publishing country Netherlands
    Document type Journal Article
    ISSN 1935-3227
    ISSN (online) 1935-3227
    DOI 10.1097/ADM.0000000000001222
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  6. Article ; Online: Prevalence and Correlates of Unmet Medical and Social Needs in Virginia's Medicaid Managed Long Term Services and Supports Program.

    Marks, Sarah J / Saunders, Heather / Shadowen, Hannah / McCray, Neil / Bachireddy, Chethan / Dagenhart, Sandra / Brown, Sandra / Guerra, Lauren / Cunningham, Peter J

    Medical care

    2023  Volume 62, Issue 2, Page(s) 93–101

    Abstract: Background: Medicaid Long Term Services and Support (LTSS) programs serve individuals with complex medical and social needs. Increasingly, state Medicaid programs are contracting with managed care organizations to administer LTSS programs.: Objectives! ...

    Abstract Background: Medicaid Long Term Services and Support (LTSS) programs serve individuals with complex medical and social needs. Increasingly, state Medicaid programs are contracting with managed care organizations to administer LTSS programs.
    Objectives: Understand the prevalence of and risk factors for unmet medical and social needs among a sample of patients within a Medicaid managed LTSS program.
    Methods: We surveyed a cross-sectional random sample of 798 community-residing individuals over 21 in Virginia who were served by the state Medicaid managed LTSS program. Outcomes of interest include 3 distinct medical needs: medical appointments, medical transportation, and prescriptions; 4 distinct social needs: housing security, food security, utility bills, and nonmedical transportation, and composite measures of unmet social and medical needs.
    Results: We found that 12.5% of our sample had any unmet medical need, while far more (62.2%) of our sample had any unmet social needs, with food insecurity being the most common. We found that members of color had almost 2 times the odds of having both unmet social and medical needs [social: adjusted odds ratio (aOR): 2.21; 95% confidence Interval (CI): (1.59, 3.09); medical aOR: 2.25

    95% CI: (1.34, 3.8)].
    Conclusion: Medicaid members may not be fully realizing the potential of LTSS programs and would benefit from both Medicaid agency and managed care organizations' strategies aimed at addressing social drivers of health. To achieve health equity for LTSS members of color, Medicaid agencies may consider policies specifically targeting racial disparities.
    MeSH term(s) United States ; Humans ; Medicaid ; Virginia ; Prevalence ; Cross-Sectional Studies ; Housing
    Language English
    Publishing date 2023-12-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 411646-x
    ISSN 1537-1948 ; 0025-7079
    ISSN (online) 1537-1948
    ISSN 0025-7079
    DOI 10.1097/MLR.0000000000001957
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  7. Article ; Online: Changes in buprenorphine waivered provider supply after Virginia Medicaid implements the addiction and recovery treatment services program and Medicaid expansion.

    Urmi, Atika Farzana / Britton, Erin / Saunders, Heather / Harrell, Ashley / Bachireddy, Chethan / Lowe, Jason / Barnes, Andrew J / Cunningham, Peter

    Journal of substance use and addiction treatment

    2023  Volume 157, Page(s) 209213

    Abstract: Background: Shortages of providers authorized to prescribe buprenorphine may limit access to buprenorphine, which studies have shown to be effective in the treatment of opioid use disorder (OUD).: Objective: To examine whether two state Medicaid ... ...

    Abstract Background: Shortages of providers authorized to prescribe buprenorphine may limit access to buprenorphine, which studies have shown to be effective in the treatment of opioid use disorder (OUD).
    Objective: To examine whether two state Medicaid policies in Virginia-the Addiction and Recovery Treatment Services (ARTS) program in 2017, and Medicaid expansion in 2019-increased the number of buprenorphine waivered providers (BWP) in Virginia, compared to other southern states in the United States that did not expand Medicaid.
    Methods: The study population includes providers authorized to prescribe buprenorphine. We compute the number of BWP per 100,000 people for the study states, overall and for different waiver limits (30, 100 or 275). Using difference-in-difference regression models, we examine changes in BWP rates for Virginia relative to nonexpansion states in the US South between 2015 and 2020.
    Results: The rate of increase in BWP was higher in Virginia after implementation of ARTS and Medicaid expansion (148 %), compared to southern nonexpansion states over the same time period (115 %). Relative to nonexpansion states in the South, BWP with patient limits of 100 or 275 increased by 7 % in Virginia after ARTS implementation in 2017, and by an additional 22 % after Medicaid expansion in 2019 (p < 0.05 each).
    Conclusions: The findings suggest that public policies that expand access to OUD treatment services-including buprenorphine treatment-may also increase the supply of providers authorized to prescribe buprenorphine, helping to alleviate shortages of BWP providers and further increasing access to care.
    MeSH term(s) Humans ; Buprenorphine/therapeutic use ; Medicaid ; Virginia/epidemiology ; Opioid-Related Disorders/drug therapy ; Opiate Substitution Treatment
    Chemical Substances Buprenorphine (40D3SCR4GZ)
    Language English
    Publishing date 2023-11-18
    Publishing country United States
    Document type Journal Article
    ISSN 2949-8759
    ISSN (online) 2949-8759
    DOI 10.1016/j.josat.2023.209213
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  8. Article ; Online: Disparities in opioid use disorder-related hospital use among postpartum Virginia Medicaid members.

    Martin, Caitlin E / Britton, Erin / Shadowen, Hannah / Bachireddy, Chethan / Harrell, Ashley / Zhao, Xue / Cunningham, Peter

    Journal of substance use and addiction treatment

    2023  Volume 145, Page(s) 208935

    Abstract: Introduction: The overdose crisis is increasingly revealing disparities in opioid use disorder (OUD) outcomes by race and ethnicity. Virginia, like other states, has witnessed drastic increases in overdose deaths. However, research has not described how ...

    Abstract Introduction: The overdose crisis is increasingly revealing disparities in opioid use disorder (OUD) outcomes by race and ethnicity. Virginia, like other states, has witnessed drastic increases in overdose deaths. However, research has not described how the overdose crisis has impacted pregnant and postpartum Virginians. We report the prevalence of OUD-related hospital use during the first year postpartum among Virginia Medicaid members in the years preceding the COVID-19 pandemic. We secondarily assess how prenatal OUD treatment is associated with postpartum OUD-related hospital use.
    Methods: This population-level retrospective cohort study used Virginia Medicaid claims data for live infant deliveries between July 2016 and June 2019. The primary outcome of OUD-related hospital use included overdose events, emergency department visits, and acute inpatient stays. Independent variables of interest were prenatal receipt of medication for OUD (MOUD) and receipt of non-MOUD treatment components in line with a comprehensive care approach (e.g., case management, behavioral health). Both descriptive and multivariate analyses were performed for all deliveries and stratified by White and Black non-Hispanic individuals to bring attention to the devastating impacts of the overdose crisis within communities of color.
    Results: The study sample included 96,649 deliveries. Over a third were by Black birthing individuals (n = 34,283). Prenatally, 2.5 % had evidence of OUD, which occurred more often among White (4 %) than Black (0.8 %) non-Hispanic birthing individuals. Postpartum OUD-related hospital use occurred in 10.7 % of deliveries with OUD, more commonly after deliveries by Black, non-Hispanic birthing individuals with OUD (16.5 %) than their White, non-Hispanic counterparts (9.7 %), and this disparity persisted in the multivariable analysis (Black AOR 1.64, 95 % CI 1.14-2.36). Postpartum OUD-related hospital events were less frequent for individuals receiving versus not receiving postpartum MOUD within 30 days prior to the event. Prenatal OUD treatment, including MOUD, was not associated with decreased odds of postpartum OUD-related hospital use in the race-stratified models.
    Conclusion: Postpartum individuals with OUD are at high risk for mortality and morbidity, especially Black individuals not receiving MOUD after delivery. An urgent need remains to effectively address the systemic and structural drivers of racial disparities in transitions of OUD care through the one-year postpartum period.
    MeSH term(s) Infant ; United States/epidemiology ; Female ; Pregnancy ; Animals ; Humans ; Medicaid ; Pandemics ; Retrospective Studies ; Virginia ; COVID-19 ; Postpartum Period ; Drug Overdose ; Colubridae ; Hospitals
    Language English
    Publishing date 2023-01-07
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ISSN 2949-8759
    ISSN (online) 2949-8759
    DOI 10.1016/j.josat.2022.208935
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  10. Article ; Online: Securing the Safety Net and Protecting Public Health During a Pandemic ; Medicaid’s Response to COVID-19

    Bachireddy, Chethan / Chen, Christopher / Dar, Mohammad

    JAMA

    2020  Volume 323, Issue 20, Page(s) 2009

    Keywords General Medicine ; covid19
    Language English
    Publisher American Medical Association (AMA)
    Publishing country us
    Document type Article ; Online
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2020.4272
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