# Impact of the New York State Medicaid Value-Based Payment Model on Opioid Use Treatment and Equity

> **NIH NIH R01** · CAMBRIDGE HEALTH ALLIANCE · 2024 · $664,922

## Abstract

PROJECT SUMMARY _RY_ ____ _
Value-Based Payment (VBP) policy, which incentivizes care quality and cost savings instead of volume-based
care, remains under-studied concerning populations with behavioral health disorders. Moreover, little is known
about VBP policy effects within Medicaid or its impact on equity. The sparse literature primarily targets broad
categorizations of substance use disorder and findings rarely extend to specific disorders, such as opioid use
disorder (OUD). In light of OUD's burden on individuals and society, there is a critical need to identify policy
levers that can improve OUD treatment and value of care for all races and ethnicities. The long-term goal is to
identify health policies that can improve healthcare inequities among persons with OUD. The overarching
objective of this proposal is to exploit a natural experiment and assess the causal impact of NYS Medicaid VBP
policy and examine the policy's equity effects on OUD-related outcomes (service use, quality, overdose, and
healthcare costs). Because factors at different levels may alter the policy's effects, we will also evaluate the
influence of individual- (e.g., comorbidities), area- (e.g., provider supply), and policy-level (e.g., VBP provider
risk-level) factors on OUD-related outcomes. The rationale for the proposed research is that understanding the
outcomes of NYS Medicaid VBP policy will inform and guide policymakers as well as states implementing
similar initiatives. We will pursue the following specific aims: 1) Assess the overall causal impact of NYS
Medicaid VBP policy on OUD-related outcomes, including service use (any OUD service use, any MOUD),
quality (MOUD initiation/ engagement/ retention, follow–up after ED visit for OUD, 30-day OUD hospital
readmission, and hepatitis-C virus screening), opioid-related overdose (non-fatal/ fatal), and costs (total and
component); 2) Determine the equity effect of NYS Medicaid VBP policy on OUD-related outcomes, including
service use, quality, overdose, and costs; and 3) Examine whether individual-, area-, and policy-level factors
moderate the effects in Aims 1-2, and provider risk-level as a potential mediator/ suppressor of VBP impact.
Building on our partnership with the NYS Department of Health, we have selected aims and outcomes that
align with NYS Medicaid Program priorities. To complete these aims, we will use longitudinal Medicaid data
linked to area-level and death certificate data and employ a robust quasi-experimental research design, which
allows for causal inferences. Results will fill a critical evidence gap regarding Medicaid VBP policy effects
among vulnerable and high-need beneficiaries, providing valuable evidence to VBP states and those
considering VBP adoption. Work from this proposal will be shared with stakeholders and policy officials in NYS
to inform the ongoing implementation of their VBP policy.

## Key facts

- **NIH application ID:** 10923201
- **Project number:** 1R01DA060795-01
- **Recipient organization:** CAMBRIDGE HEALTH ALLIANCE
- **Principal Investigator:** Michael Flores
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $664,922
- **Award type:** 1
- **Project period:** 2024-08-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10923201

## Citation

> US National Institutes of Health, RePORTER application 10923201, Impact of the New York State Medicaid Value-Based Payment Model on Opioid Use Treatment and Equity (1R01DA060795-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10923201. Licensed CC0.

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