West Virginia Medical Journal - 2022 - Quarter 3 | Page 36

FIGURE 3

Percent Increase of Prescribers Receiving a Medicaid Waiver for Buprenorphine vs . Patients per Prescriber

Data from WV Medicaid shows an increase in both the number of prescribers in WV approved for an H3W waiver to prescribe buprenorphine for OUD treatment from 2016 ( 192 prescribers ) to 2019 ( 413 prescribers ) and those who are actively prescribing under the waiver ( 131-300 ). There was no significant difference in the percentage of Approved Prescribers who are active prescribing ( p > 0.2887 ) between 2016 and 2019 . The overall number of patients receiving prescriptions increased each year ( 2,420 in 2016 ; 10,742 in 2017 ; 14,609 in 2018 ; and 16,336 in 2019 ). The number of patients per approved prescriber and active prescribers increased annually from 2016 to 2018 ( Approved 12.60 to 47.43 and Active 18.47 to 63.24 ) then decreased in 2019 ( 39.55 and 54.45 , respectively ).

strongly agreed / agreed that MAT is effective . Nearly all MAT providers ( 96.6 %, N = 29 ) agreed that there was a need for more MAT in their area ( p > 0.001 ), while most ( 86.2 %, N = 29 ) strongly disagreed / disagreed with the statement that the number of providers willing to manage MAT is adequate . Nearly all respondents to this survey ( 93.1 %, 274 of 294 ) strongly agreed / agreed that patients with OUD benefit from MAT . A majority ( 79.3 %, N = 294 ) of providers strongly agreed / agreed that they felt adequately trained to treat OUD with MAT , and 78.6 % reported that they felt comfortable treating / managing OUD with MAT . Approximately 12 % of all providers surveyed ( n = 294 ) reported that their practice included MAT , and 22.7 % ( N = 294 ) reported that they would be “ probably willing / definitely willing ” to expand their practice to include new or additional patients for MAT . Of respondents providing primary care ( 25.1 % of 294 ) and specialty care ( 19.5 % of 294 ), 19.3 % of primary care providers and 26.0 % of specialty providers were “ definitely willing ” to expand in MAT . Nearly half of primary care ( 45.8 %) and specialty care ( 48.0 %) providers surveyed were “ not willing ” to expand MAT ( Figure 1 ).

Respondents who currently provide MAT services are divided in regard to the significance of legislative barriers on their practice . These respondents overwhelmingly agreed that they have support from staff , fellow physicians , and their institutions to provide MAT services . In contrast , “ Regulations / legislative rules ,” “ Lack of behavioral health coverage ,” and “ Lack of support for prescribers ” were the top barriers selected by all respondents to expanding practice into MAT . These findings demonstrated a disparity between All Provider perceptions of barriers ( external ) vs . MAT Provider perceptions of promoters ( staff and institutional support ) ( Figure 2 ).

Figure 3 illustrates a 215 % increase in the number of prescribers approved by WV

Medicaid for an H3W waiver to prescribe buprenorphine for OUD treatment , which is a requirement for providing MAT services . In 2016 , 192 prescribers were waivered as compared to 413 prescribers in 2019 . Those who were actively prescribing under the waiver also increased from 131 to 300 ( 229 %) during this timeframe . Of those prescribers approved by WV Medicaid to provide MAT services , 25-32 % were not active year to year . The number of patients per approved provider increased from 12.60 patients in 2016 , to 47.43 in 2018 , before decreasing to 39.55 in 2019 . Patients per active provider followed a similar pattern , peaking in 2018 at 63.24 patients per MAT provider before dropping to 54.45 patients per provider in 2019 ( Figure 3 ).

All respondents were asked the final openended question , “ Do you have any additional comments or insights on the above questions ?” to which 46 participants responded . Many respondents reiterated the

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