Taxpayers pay billions for treatment
By Chip Rowe
Two reports by a public policy think-tank in Albany released this month found that the number of deaths attributed to opioid overdoses continues to rise in New York and that taxpayers cover two-thirds of the costs of treatment.
The Rockefeller Institute of Government analyzed the most recently available state tally of opioid deaths, from 2016, as well as the source of payments for medical treatment.
The institute found a 29 percent increase in opioid-related deaths in New York over 2015, the largest year-to-year increase since 2010. Notably, deaths increased 39 percent in New York City and 23 percent in the rest of the state, a reverse of the previous trend.
In 2016, nearly 4,000 New Yorkers died of opioid overdoses, including 67 in Dutchess County (a 3 percent increase from the previous year), 23 in Putnam (a 21 percent increase) and 150 in Westchester (a 28 percent increase).
The increase statewide was 4.5 percent. By comparison, the death rate increased 21 percent in Washington, D.C., 13 percent in Maryland and 11 percent in Pennsylvania.
In New York, the largest rise in deaths was among 25- to 34-year-olds, at 44 percent, according to the data. Deaths among blacks increased 57 percent versus 26 percent for whites.
“Recent reports have suggested that opioid deaths may be slowing in some parts of New York,” the report noted, although figures for 2017 will not be available until early next year.
The Rockefeller Institute also analyzed payment information for treatment for opioid abuse at hospitals and other medical facilities, the vast majority of which is in-patient.
It calculated that in 2015 in New York, 33 percent of treatment was paid for by private insurance and a total of 65 percent by taxpayers through Medicaid (43 percent, for low-income residents) or Medicare (22 percent, for the elderly). The source of payments for the remaining 2 percent were unknown or through other means.
The number of opioid-related visits paid for by Medicaid doubled between 2011 and 2015, according to the analysis, and at a faster rate than Medicare or private insurance. In 2016, Medicaid paid $8.7 billion of the $21.4 billion spent by insurers on opioid treatment in the U.S. Medicare paid another $6.4 billion.
Notably, while the “face of the epidemic” has been poor, mostly white, rural counties, the institute found that most treatment paid for by Medicaid takes place in relatively affluent, “less-white” counties. It suggested this may be because doctors are less accessible in poor counties and/or more reluctant to take on Medicaid patients than larger institutions, which can absorb the federal program’s lower insurance reimbursements.
Both reports are available at rockinst.org.