Leaving Prison and Connecting With Medical Care: Medicaid Expansion, Treatment Access and Outcomes for Opioid Use Disorder and Hepatitis C Infection

At a Glance

Wisconsin’s prison population is faced with high rates of Hepatitis C infection (HCV) and opioid use disorder, both of which have dire consequences if left untreated. Thus, individuals need to be connected to care as they re-enter society, but research is needed to identify effective interventions.

The Challenge

Hepatitis C infection (HCV) and opioid use disorder are related epidemics that disproportionately affect criminal justice-involved individuals. In Wisconsin, the prevalence of HCV among inmates is 12.5 percent compared to only 1 percent in the general population; and in 2016, 69 percent of adult inmates needed substance abuse treatment. These conditions have dire consequences if left untreated: Individuals with HCV risk infecting others, cirrhosis and liver cancer; and drug overdose is the leading cause of death among recently-released prisoners. This research evaluates how recent expansions of Medicaid eligibility and the addition of prison-based Medicaid enrollment have affected treatment access, use and outcomes for opioid use disorder and HCV for adults released from state prisons.

Project Goals

The long-term objective of this research is to prevent opioid overdose deaths and reduce HCV transmission among Wisconsin’s criminal justice-involved population by improving the transition to care when individuals are released from prison. To this end, the study will quantify the influence of opioid and HCV treatment and prevention resources on the relationship between Medicaid and post-incarceration healthcare use, mortality and reincarceration. The findings have the potential to inform federal and state efforts to identify policies that will address these issues.