Medicaid Member Use Of MOUD Increases to 69%

May 4, 2026

Among Medicaid beneficiaries with opioid use disorder (OUD), medication-assisted treatment rose from 60.0% in 2018 to 69.1% in 2023. Although uptake of medications for opioid use disorder (MOUD) increased, treatment continuation for at least 180 days declined, falling from 62.6% to 57.7%.

Between 2018 and 2023, federal and state governments rolled out many policies and programs to increase use of MOUD. These included expanding coverage for MOUD under state Medicaid programs, easing burdens for clinical professionals to prescribe buprenorphine, easing restrictions on take-home methadone doses, making telehealth access to MOUD prescriptions easier, and requiring more addiction treatment programs to offer MOUD.

The three states with the largest increases in MOUD were: Kansas, rising from 17.4% to 53.7%; Arkansas, rising from 20.2% to 56.6%; and Utah, rising from 27.6% to 67.5%.

The three states with the largest retention drops were: California, declining from 56.6% to 38.0%; Idaho, declining from 69.7% to 52.6%; and Minnesota, declining from 72.9% to 56.1%.

During the same period, the percentage of beneficiaries with OUD who had an OUD-related hospitalization or emergency department visit declined slightly, from 10.9% in 2018 to 10.6% in 2023.

Researchers conducted a cross-sectional study of 126.4 million beneficiary-year observations from 2018 through 2023 involving adults aged 18 to 64 years who were not dually enrolled in Medicare. The dataset included 47 states and the District of Columbia (DC). The share of beneficiaries diagnosed with OUD declined from 4.2% in 2019 to 3.6% in 2023.

Most states showed mixed but generally positive trends in OUD treatment with medications:

• The decline in OUD diagnosis was observed in 34 of the 48 jurisdictions included in the analysis
• An increase in the percentage of beneficiaries with OUD treated with MOUD occurred in 45 of the 48 jurisdictions
• The decrease in the percentage of beneficiaries who continued MOUD for at least 180 days was driven by declines in 29 of the 48 jurisdictions
• The decline in the percentage of beneficiaries with OUD who had an OUD-related hospitalization or emergency department visit was driven by declines in 17 states but was offset by increases in 31 states

These findings were presented in Cascade of Care for Opioid Use Disorder Among Medicaid Beneficiaries by Thanh T. Lu, Ph.D.; William N. Dowd, Ph.D.; Tami L. Mark, Ph.D.; and colleagues. The researchers concluded that the increase in MOUD may have contributed to reductions in overdose deaths among adult Medicaid beneficiaries.

The full text of Cascade of Care for Opioid Use Disorder Among Medicaid Beneficiaries was published on April 22, 2026, by JAMA Network Open. A free copy is available (accessed April 29, 2026).

For more information, contact: Tami L. Mark, Ph.D., Health Economist, RTI International, 3040 East Cornwallis Road, Durham, North Carolina 27709; Email: tmark@rti.org; Website: https://www.rti.org/