• Rohit Abraham, Elizabeth Wilkinson, Yalda Jabbarpour, Stephen Petterson, and Andrew Bazemore.
• From Boston University School of Medicine, Departments of Family Medicine and Psychiatry, Boston, MA (RA); Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (EW, YJ, SP, AB). rohit.abraham@bmc.org.
• J Am Board Fam Med. 2020 Jan 1; 33 (1): 9-16.

IntroductionOpioid use disorder (OUD) is a major and growing public health concern, and Medicare patients have nearly double the proportion of OUD prevalence compared with those with commercial insurance. This study examines provider-level characteristics to delineate the wide variation behind buprenorphine provision, which is the mainstay of medication-assisted treatment for OUD.MethodsUsing Medicare Part D Public Use Files claims data from 2013 to 2016 in all states, we assessed prescribing patterns of buprenorphine formulations for the specialties of family medicine, internal medicine, psychiatry, and general practice. We incorporated data from 2013 to 2016 American Medical Association Physician Masterfile to model various provider- and area-level characteristics as predictors of buprenorphine prescriber status.ResultsFamily medicine and internal medicine comprise nearly two-thirds of the outpatient buprenorphine prescriber population for Medicare beneficiaries. Yet, both specialties also have the lowest proportion of active buprenorphine prescribers compared with psychiatrists and general practitioners. Additional characteristics associated with buprenorphine provision include male sex, osteopathic training, Northeast region, US undergraduate medical education, more years in practice, and a higher proportion of dual-eligible patients.ConclusionsPrimary care specialties, such as family medicine and internal medicine, currently comprise a significant majority of the US buprenorphine prescriber population for Medicare beneficiaries. Future policies should target specific demographics to enable greater patient access from physicians who are characteristically less likely to prescribe buprenorphine to increase overall capacity.© Copyright 2020 by the American Board of Family Medicine.

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