A telemedicine bridge clinic increases buprenorphine engagement and reduces emergency department visits among medicaid patients with opioid use disorder.

PURPOSE: Medications for opioid use disorder improve survival and health outcomes, yet access remains limited. Telemedicine bridge clinics offer rapid, low-barrier treatment initiation and retention. This study evaluated whether care through a telemedicine bridge clinic was associated with improved medication engagement, emergency department (ED) utilization, and Medicaid expenditures compared with usual office-based care. METHODS: Pennsylvania Medicaid claims were linked with clinical data to identify adults aged 18-64 who received care from a telemedicine bridge clinic between April 2020 and July 2022. Bridge clinic patients were matched to up to four Medicaid enrollees initiating care with other opioid use disorder providers based on demographic and eligibility characteristics. Difference-in-differences models compared medication use, proportion of days covered (PDC) by medications for opioid use disorder, and ED utilization in the 6 months before and after the index visit. Medicaid expenditures were examined descriptively. RESULTS: The sample included 552 bridge clinic patients and 2208 matched comparison patients. A greater proportion of bridge clinic patients filled a buprenorphine prescription in the month after qualifying encounter (91.3% vs. 73.6%). Relative to the comparison group, bridge clinic patients experienced a 6.9% increase in medication PDC and an 18.2% relative reduction in the proportion with any ED visit. Medicaid expenditures were lower among bridge clinic patients, driven primarily by lower inpatient spending. CONCLUSIONS: Telemedicine bridge clinic care was associated with improved continuity of medication treatment and reduced ED utilization among Medicaid enrollees, supporting its role as an effective, low-barrier model for opioid use disorder care.