Association of Incarceration with Utilization and Costs for Patients with Opioid Use Disorder in a Medicaid Accountable Care Organization

Incarcerated individuals with opioid use disorder face many barriers to accessing healthcare and related services, putting them at high risks of relapse, drug overdose, and hospitalization after release from prison. In July 2023, justice-involved populations became a priority area for MassHealth’s Medicaid Accountable Care Organizations (ACOs), a financing and delivery model that holds provider organizations responsible for quality and costs and incentivizes care coordination and population health strategies.

To study the role of Medicaid policies and ACOs for Medicaid enrollees involved with the criminal legal system, this pilot study will construct a novel, individually linked dataset for a Massachusetts Medicaid ACO serving a region with high rates of opioid-related mortality. This project will also examine the burden of incarceration among people with opioid use disorder in a Medicaid ACO population and characterize patterns of acute care utilization (emergency department and hospital visits) and costs after release from incarceration.

Ben Bovell-Ammon is a general internist and researcher at the University of Massachusetts (UMass) Chan Medical School–Baystate and Baystate Health in Springfield, MA. He practices addiction medicine at a community health center in Springfield and primary care at the Hampden County jail. As a researcher, he studies innovations in policy and healthcare delivery models to improve outcomes for individuals involved with the criminal legal system, especially those reentering to the community after incarceration. After receiving his medical degree from the University of Texas Southwestern Medical School and a master’s degree from the Harvard T.H. Chan School of Public Health, he completed a combined residency program in Internal Medicine and Preventive Medicine at Boston Medical Center/Boston University and a hybrid research fellowship at Boston Medical Center and Brown University/The Miriam Hospital.