New Quality Measures Reveal Wide Variation in Opioid Treatment Programs’ Medicaid Patient Retention Rates

New Quality Measures Reveal Wide Variation in Opioid Treatment Programs’ Medicaid Patient Retention Rates

January 24, 2026 discoverhiddenusacom Health

A new study reveals significant disparities in patient retention rates among opioid treatment programs (OTPs) across the United States. Published in JAMA Network Open, the research, conducted by experts at RTI International, highlights a critical need for quality improvement initiatives within these programs.

Retention: A Key to Recovery

Treatment retention is a crucial factor in successful recovery from opioid use disorder. According to Tami Mark, Ph.D., a Distinguished Fellow at RTI and lead author of the study, retention is “one of the strongest predictors of recovery and survival for patients experiencing opioid use disorder.” The study sought to establish consistent benchmarks for OTPs to assess their performance and identify areas for enhancement.

Wide Variation in Program Performance

Researchers analyzed Medicaid claims data from 2018 to 2023, encompassing over 1,100 OTPs, 432,000 treatment episodes, and 261,000 patients. The analysis revealed substantial differences in retention rates. Typically, 61% of Medicaid patients remain in care beyond the first month. However, the lowest-performing 25% of programs only retain 40% of patients for at least one month.

Did You Know? RTI researchers used data spanning from 2018 to 2023 to create case-mix adjusted retention measures.

Retention Rates Over Time

The disparities in retention become more pronounced over longer treatment periods. At 30 days, OTPs in the top 75% retained 73.5% of participants, compared to just 40.9% in the bottom 25%. At 90 days, the top programs retained 54.8% of patients, while those in the bottom quartile retained only 22.2%. After 180 days, retention rates were 40.5% for the top group and a significantly lower 11.4% for the bottom group.

Expert Insight: These findings suggest that substantial opportunities exist to improve the effectiveness of opioid treatment programs by focusing on strategies to enhance patient engagement and retention.

What Could Happen Next

The study’s findings could prompt increased scrutiny of OTP performance metrics. It is likely that policymakers and healthcare organizations may explore strategies to incentivize programs to improve retention rates. Further research could focus on identifying the specific factors contributing to the observed disparities, potentially leading to targeted interventions. OTPs may also prioritize implementing evidence-based practices designed to enhance patient engagement and support.

Frequently Asked Questions

What data was used for this study?

RTI researchers used Medicaid claims data from 2018 to 2023, including data from more than 1,100 OTPs, 432,000 treatment episodes, and 261,000 patients.

Who conducted this research?

The research was conducted by experts at RTI International, an independent scientific research institute. Tami Mark, Ph.D., was the lead author.

Why is retention important in opioid treatment?

According to the study, retention is one of the strongest predictors of recovery and survival for patients experiencing opioid use disorder.

How might these findings impact individuals seeking treatment for opioid use disorder?