About
The Data
The data included in this dashboard comes from South Carolina’s Medicaid enrollees in 2021. It is important to understand the treatment experiences of South Carolina residents enrolled in Medicaid because they represent a very large proportion of the state’s population.
What is the Medicaid Program?
Medicaid is the United States’ health insurance program for low-income Americans. In South Carolina, Medicaid provides health coverage for children, pregnant women, women during the first year after the birth of their child, caretaker parents, elderly adults, and people with disabilities who meet income eligibility criteria. Over one million South Carolinians are enrolled in Medicaid each year—roughly one in three residents in the state.10 Medicaid coverage includes a broad array of psychosocial treatment services and all three forms of medications for opioid use disorder.
Data and Study Population
South Carolina collects healthcare claims for all inpatient and outpatient medical services and prescriptions paid for by the Medicaid program. These data were made available under a data use agreement to researchers at the University of South Carolina after approval from the Office of Revenue and Fiscal Affairs, the Department of Health and Human Services, and the Department of Alcohol and Other Drug Abuse Services. Guided by the Opioid Cascade of Care framework, the research team used claims data for 464,493 Medicaid enrollees between the ages of 18 and 64 who were enrolled in Medicaid for at least 10 months of 2021.
Several counties are collapsed into larger geographic catchment areas due to small numbers of patients at some stages of the Cascade: the Barnwell area includes Allendale, Bamberg, Barnwell, and Hampton counties; the Greenwood area includes Abbeville, Edgefield, Greenwood, McCormick, and Saluda counties; and the Newberry area includes Chester, Fairfield, and Newberry counties. Counts of 10 and under are suppressed in order to comply with data protection and confidentiality requirements.
This study was approved by the University of South Carolina’s Institutional Review Board.
Dashboard Measures
Using these claims, treatment cascade rates were estimated using measures adapted from measure specifications that have been validated using Medicaid and other health insurance claims data. The Centers for Disease Control and the National Institute for Drug Abuse have referenced the Opioid Cascade of Care and encouraged healthcare systems, counties, and states to use these measures as a guide for how to improve treatment for patients with opioid use disorder.
These measures are based in part on National Committee for Quality Assurance’s (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) measures, which are some of the most widely used insurance plan performance measures. HEDIS measures are validated, claims-based measures that give a standardized format to compare health system and plan performance across states and years. The NCQA and NQF provide guidelines for creation of these variables (for example, psychosocial and medication initiation within 14 and 34 days, and diagnosis in the first 10.5 months of the year) that help standardize measures across plans, states, and research teams.
Limitations of Data
Data is representative of only individuals using Medicaid as their health insurance and does not represent individuals who are uninsured or have private insurance. Medicaid data might miss prescribed, unused, or non-reimbursed medical care or services, as it only captures care provided when a bill was submitted. Percentages displayed are estimates based on the data and do not reflect exact counts. State regions are based on the South Carolina Department of Public Health Regions. These data reflect trends in opioid use disorder diagnosis and treatment receipt during the COVID-19 pandemic, which may differ significantly from such trends during the non-pandemic period.
Inclusion Criteria
Adults aged 18-64 years old who were enrolled in Medicaid for at least 10 months of 2021 are included in this data.