State Policies and Buprenorphine Prescribing by Nurse Practitioners and Physician Assistants. (December 2022)

• Record Type: Journal Article
• Authors: Harrison, Jordan M.; Kerber, Rose; Andraka-Christou, Barbara; Sorbero, Mark; Stein, Bradley D.
• Is Part Of: Medical care research and review. Volume 79:Number 6(2022)
• Page Start: 789
• Page End: 797
• Publication Date: 2022-12
• Subjects: nurse practitioners -- physician assistants -- buprenorphine -- opioid use disorder -- behavioral health care -- Medicaid; Medical care -- United States -- Periodicals; Medical care -- Periodicals; Medical care -- Research -- United States -- Periodicals; Medical care -- Research -- Periodicals; Medical economics -- United States -- Periodicals; Medical economics -- Periodicals; 362.10973
• DOI: 10.1177/10775587221086489
• Languages: English
• ISSNs: 1077-5587

Abstract

Nurse practitioner (NP) and physician assistant (PA) prescribing can increase access to buprenorphine treatment for opioid use disorder. In this cross-sectional study, we used deidentified claims from approximately 90% of U.S. retail pharmacies (2017–2018) to examine the association of state policies with the odds of receiving buprenorphine treatment from an NP/PA versus a physician, overall and stratified by urban/rural status. From 2017 to 2018, the percentage of buprenorphine treatment episodes prescribed by NPs/PAs varied widely across states, from 0.4% in Alabama to 57.2% in Montana. Policies associated with greater odds of buprenorphine treatment from an NP/PA included full scope of practice (SOP) for NPs, full SOP for PAs, Medicaid pay parity for NPs (reimbursement at 100% of the fee-for-service physician rate), and Medicaid expansion. Although most findings with respect to policies were similar in urban and rural settings, the association of Medicaid expansion with NP/PA buprenorphine treatment was driven by rural counties.