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Sharing data to find treatments that work

Social work researchers in North Carolina are helping develop a multi-state network that will use Medicaid data to identify successful treatment options for medical situations that have broad national concern, including opioid use disorder and at-risk pregnancies.

The network, called MODRN (Medicaid Outcomes Distributed Research Network), is supported by Academy Health, a Washington, D.C.-based nonprofit organization that provides programs, databases, education, strategic planning and other services for health care organizations.

North Carolina is one of eleven states in the network. These states (including Delaware, Kentucky, Maryland, Michigan, Ohio, Pennsylvania, Tennessee, Virginia, West Virginia and Wisconsin) represent a geographic curve through the Appalachian region, where the opioid epidemic has hit hardest in the United States.

“Health problems often cross state borders,” explains Paul Lanier, Ph.D., associate professor at UNC School of Social Work. “Working together, we can learn from each other.”

For example, researchers in each state will examine which approaches to quality treatment are most successful — for example, if opioid treatment programs use only medications (methadone, naltrexone or buprenorphine, dispensed daily at a treatment clinic) to treat substance use disorders or if they also use behavioral therapy as part of the treatment plan.

Although information like this is available within each state, states haven’t been able to compare results in real-time previously and serve as laboratories of innovation, Lanier says.

“Data security and privacy regulations are the main barrier” to sharing Medicaid information between states, Lanier adds. This information includes data about access, quality and costs — data that could allow health organizations in each state to analyze how their policies and practices compare with those from other states. Because MODRN allows each state to retain its own data, researchers can share findings while maintaining security and privacy.

“We’ve gone past the pilot stage of the network,” Lanier says. “This is working.”

Because Lanier studies evidence-based practices that can strengthen families, he is especially excited about the potential for MODRN to uncover better solutions for children and their families in North Carolina.

“The research can help thousands of families here in N.C.,” Lanier says, noting that over one-half of all births in North Carolina are on Medicaid. “We can look at birth outcomes for vulnerable populations.

“We’re looking for movement in the state indicators we need to do better on,” he adds, explaining that the data can suggest which state policies are working and which aren’t. For example, researchers in North Carolina will look at the impact of well-child visits and of different treatments for infants suffering withdrawal from neonatal abstinence syndrome, as well as other data.

However, Lanier cautions that there’s no one-size-fits-all solution for many health and welfare issues.

“It’s not as simple as supply and demand, or saying we just need more providers,” he says. “There’s not good access for people who are uninsured … so we need better access to providers, higher-quality service, and follow-ups with behavioral health experts.”

Collaboration between the state agencies responsible for healthcare and the state universities who can assess the data will be a key to the network’s success, Lanier believes.

“The ‘secret sauce’ to all this is having a university with a strong relationship to state government,” he says, adding that UNC School of Social Work researchers have a long history of collaborating with the North Carolina Department of Health and Human Services.

Each of the eleven states in the network has a state-university partnership to support the MODRN research. Together, the states account for nearly 17 million Medicaid enrollees.

For more info on MODRN, visit: