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Initiation & Engagement of Alcohol & Other Drug Dependence Treatment

Treatment for alcohol and other drug (AOD) dependence can improve health, productivity, and social outcomes. It can also save millions of dollars on health care and related costs.

Explore the percentage of adults age 18 and older with a new episode of alcohol and other drug (AOD) dependence who:

  • Initiated timely treatment within 14 days of diagnosis (Initiation rate)
  • Continued engagement with treatment services by having two or more follow-up visits within 34 days (Engagement rate)

This measure reports the treatment initiation and engagement rates among beneficiaries with the following diagnoses:

  • Total AOD Abuse or Dependence
  • Alcohol Abuse or Dependence
  • Opioid Abuse or Dependence
  • Other Drug Abuse or Dependence

Higher rates are better.

The purple dashed line represents the median, or middle of all values reported.

This measure reports on the percentage of adults age 18 and older with a new episode of AOD dependence who (1) initiated timely treatment within 14 days of diagnosis (initiation rate) and (2) initiated treatment and had two or more additional AOD services within 34 days of the initial visit (engagement rate).

States voluntarily report on Initiation & Engagement of Alcohol & Other Drug Dependence Treatment (IET-AD) as part of the Core Set of Adult Health Care Quality Measures. These data show performance rates for states that voluntarily reported the measure using Adult Core Set measure specifications.

The included populations for Adult Core Set measures can vary by state. For example, some states report data on certain populations such as those covered under managed care but not those covered under fee-for-service (FFS). This variation in data can affect measure performance and comparisons between states.

Specifications for this measure changed substantially for Federal Fiscal Year (FFY) 2018. Rates are not comparable with rates reported for previous years.

Total AOD Abuse or Dependence

Alcohol Abuse or Dependence

Opioid Abuse or Dependence

Other Drug Abuse or Dependence

Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports as of June 3, 2019 for the Adult Core Set FFY 2018 reporting cycle; see 2018 Child and Adult Health Care Quality Measures. For more information about Initiation & Engagement of Alcohol & Other Drug Dependence Treatment (IET-AD) visit Adult Health Care Quality Measures.

Notes:

HI and RI did not report separate rates for Alcohol Abuse or Dependence, Opioid Abuse or Dependence, or Other Drug Abuse or Dependence. The following states did not report either the Initiation or Engagement rate for any diagnosis cohorts: AK, AR, CO, DC, GA, ID, IN, ME, MI, MN, MT, ND, NE, NJ, UT, VA, and WY.

The Adult Core Set specifications include guidance for calculating this measure using the administrative method. Unless otherwise specified, the administrative data source is the state’s Medicaid Management Information System (MMIS) and/or data submitted by managed care plans, including behavioral health plans.

Unless otherwise specified:

  • States used Adult Core Set specifications, based National Committee for Quality Assurance (NCQA) 2018 specifications. The following state used NCQA 2017 specifications: NV.  
  • Denominators are assumed to be the measure-eligible population for states using the administrative method. Some states reported exclusions from the denominator, as noted in the state-specific comments.
  • The measurement period for this measure was January 1, 2017 to November 30, 2017. AZ reported data for FFY 2016.
  • Rates displayed reflect state reporting for Medicaid enrollees ages 18 to 64 (24 states) or age 18 and older (9 states). HI reported results for age 13 and older.

AHRQ = Agency for Healthcare Research and Quality; CCO = Coordinated Care Organization; CHIP = Children’s Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CMO = Care Management Organization; CY = Calendar Year; ED = Emergency Department; EHR = Electronic Health Record; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner.