Volume 3, Issue 4, April 2025

Opportunities for patients to be prescribed medications for opioid or alcohol use disorder (MOUD, MAUD) remain relatively low in specialty behavioral health (BH) programs—even more so in substance use disorder programs. Overall, national organization accreditation was positively and state agency licensure/certification negatively associated with programs offering MOUD/MAUD; however, there was wide variation across states in these associations. Low rates of MOUD/MAUD availability in specialty BH programs highlight missed policy opportunities to further improve MOUD/MAUD availability in specialty BH programs.

Although Medicaid coverage of doula services is slowly shifting who can access doula support, a coverage gap is emerging for privately insured individuals who desire doula support but for whom cost is a barrier. In this study, we identified factors that could move the needle toward increased commercial coverage of doula services.

Are Medicare Advantage (MA) patients cared for by primary care practices that deliver more telehealth experience better care quality and utilization outcomes? Using a quasi-experimental approach to examine the national effects of telehealth use among MA enrollees, we found that patients at practices delivering relatively high proportions of care via telehealth vs no telehealth experienced a 13.4% decrease in in-person office evaluation and management (E&M) visits, but similar levels of total (in-person plus telehealth) E&M visits and a 4.8% decrease in total emergency department visits, relative to mean pre-pandemic levels.

This commentary, authored by leaders at the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS), sets the foundation for the Health Affairs Scholar Featured Series on emergency department (ED) boarding. The article frames the issue as a critical symptom of overload and breakdown of the larger health care delivery system, not a problem specific to emergency departments, drawing broad and meaningful connections to patient safety and quality, health care economics, health policy, and regulatory structures. It illustrates the importance of this issue to all. It provides both a call to action for readers new to the topic and a grounding for subsequent articles in the Featured Series that will further develop the impacts, theoretical framework and literature to date, and critical evaluation of the topic from various perspectives.