Comparing the Care and Distance Traveled by Rural and Urban Children and Adolescents With Medicaid Insurance and Opioid Use Disorder
Link
Date
04/2026
Description
Access to opioid use disorder (OUD) treatment is challenging for adolescents, as few treatment facilities and clinicians serve this population. This brief examines the health care experiences of rural and urban Medicaid-insured children and adolescents (ages 0-17) with OUD, describing the number of health care visits and the distance they traveled to receive care.
Key Findings:
- Among the 13,002 children and adolescents aged 0-17 with an OUD diagnosis enrolled in Medicaid in 2019, 18.9% lived in rural areas.
- Urban children and adolescents had slightly more health care visits per 1,000 children and adolescents (69,101) than rural children and adolescents (61,766).
- The mean number of health care visits per beneficiary in 2019 was significantly higher for urban (74.8) than rural (67.5) children and adolescents, though there was no difference in the median number of visits by geography (35 and 33, respectively).
- Rural children and adolescents faced substantially greater travel burdens than urban children and adolescents. On average, one-way driving times were approximately twice as long for rural children and adolescents as for their urban peers (100.7 vs. 55.5 minutes). The same pattern held true for median driving times (57 vs. 26 minutes).
- Rural children and adolescents were significantly more likely to live in counties without a Drug Enforcement Administration clinician with an X-waiver (15.0% vs. 1.4%).
Center
WWAMI Rural Health Research Center
Authors
Janessa Graves, Lisa Garberson, Sara Woolcock, Holly Andrilla