Whether or not a patient is getting in-network substance use disorder care could play a significant role in their treatment retention.

A new study published in Health Affairs by substance use disorder provider Ophelia found that 72.3% of its patients with in-network benefits stayed in treatment for at least 180 days. Meanwhile, only 48.1% of out-of-network or uninsured patients stayed in treatment for the full 180 days.

“When people are ready to seek OUD treatment, there should be no financial hurdles preventing them from receiving care,” Dr. Arthur Robin Williams, chief medical officer of Ophelia, said in a statement. “This study is a call to our entire healthcare system to do more to eliminate barriers to OUD treatment and for health networks to be more expansive and offer a broad range of treatment providers, including telehealth providers. We need to help people stay on track with treatment plans by making care affordable.”

The research included 3,842 patients. That broke down to 1,613 in-network patients and 2,229 cash-pay patients. Both sets of patients received medication-assisted-treatment of opioid use disorder through Ophelia’s virtual care platform.

Researchers found that uninsured patients were more likely to stay in the program for 180 days than out-of-network patients. Both uninsured and out-of-network patients paid a flat monthly fee of $195.

“We found that patients able to use in-network benefits were 50% more likely to successfully retain at 6 months in care … compared with cash-pay patients,” authors of the study wrote. “This disparity persisted when restricting to insured patients and comparing in-network with out-of-network patients, suggesting that it is not likely to be driven only by unmeasured differences between insured and uninsured patients. These findings together indicate that the ability to use insurance benefits to cover service costs may have a meaningful impact on patient retention in [telehealth-based opioid treatment] settings.”

This research comes as many patients on Medicaid have lost their insurance in the wake of post-COVID-19 redetermination.

“As the prevalence of OUD among Medicaid beneficiaries is approximately 4-fold that among the general population, Medicaid is the number one payer of addiction care in the United States,” authors of the study wrote. “Following the passage of the Affordable Care Act in 2014, this is especially true in Medicaid-expansion states. Therefore, the pause on Medicaid disenrollments under the COVID-19 public health emergency likely allowed for uninterrupted coverage to disproportionately marginalized patient populations in most need of treatment amid the opioid crisis.”