Approximately 60 percent of U.S. counties have at least one outpatient substance use disorder (SUD) facility that accepts Medicaid, although the number is much lower in southern and Midwestern states, according to a study by Janet R. Cummings, Ph.D., of Emory University, Atlanta, and colleagues.

The expansion of Medicaid under the Patient Protection and Affordable Care Act of 2010 sets the stage for helping address long-standing gaps in access to SUD treatment for states that opt-in to the expansion, according to the study background.

Researchers used data from the 2009 National Survey of Substance Abuse Treatment Services file and the 2011-2012 Area Resource file to examine county-level SUD facility availability in the U.S. and whether race/ethnicity, poverty and insurance are associated with availability.

Study results indicate SUD facilities that accept Medicaid are less common in southern and Midwestern states than in other areas of the country, and that U.S. counties with a higher percentage of black, rural, and/or uninsured residents are less likely to have one of those facilities.

"Although the Medicaid expansion will provide states with an opportunity to bolster the SUD treatment system with new federal funds, additional policies may need to be implemented to ensure that there is an infrastructure in place to serve new enrollees who seek SUD treatment across local communities," the authors conclude.