What Medicaid acceptance looks like at North Carolina substance use treatment centers

Overdose deaths tragically rose during the COVID-19 pandemic, sparking renewed calls for awareness of substance use disorders and access to treatment.

The once-in-a-century global health crisis had widespread impacts on physical and mental health and coincided with America's worsening fentanyl epidemic. And though calls have been made to expand access to treatment, people with substance use disorders often face barriers to getting the help they need to survive addiction to deadly substances like opioids.

Stigmatization of these disorders, a lack of capacity at treatment centers where waitlists are common, and unaffordability of treatment present some of the most critical challenges to Americans' ability to get help, researchers have found.

And the population using Medicaid is more likely than those on commercial insurance to live with a substance use disorder: 21% of Medicaid users had some form of SUD compared to 16% of commercially insured Americans, according to KFF, the nonpartisan health research firm formerly known as Kaiser Health News.

In order to visualize how Medicaid acceptance rates can vary by state, Ophelia analyzed data collected by the Substance Abuse and Mental Health Services Administration in its survey of substance use disorder treatment centers nationwide. The data used in this analysis covers both public and private institutions, totaling nearly 15,000 locations nationwide.

American treatment centers do not universally accept Medicaid, and only 74% of them took it as payment in 2022, according to SAMHSA. Medicaid even covers methadone treatment for opioid use disorder, though the fraction of treatment centers offering opioid treatment programs also do not accept Medicaid universally. And when patients can't utilize insurance, their only option is to pay out of pocket.

See the full national analysis here.

North Carolina by the numbers

Substance use disorder treatment centers that accepted Medicaid in 2022: 73.8%
Percentage point change in acceptance rate from prior year: +1.1 percentage points
Total facilities: 561

Top states for Medicaid acceptance:
1. Idaho 94.8%
2. Ohio 93.4%
3. Vermont 93.3%
4. Wyoming 92.9%
5. Iowa 91.6%

Worst states for Medicaid acceptance:
1. Hawaii 33.1%
2. California 45.6%
3. Florida 47%
4. Georgia 55.3%
5. Mississippi 60.4%

This story features data reporting and writing by Dom DiFurio and is part of a series utilizing data automation across 51 states.