Peer-reviewed publications by Tamara Beetham, PhD, MPH on health economics, healthcare access, and addiction treatment policy.https://www.tamarabeetham.com/en-ushttps://www.tamarabeetham.com/publications/medicare-appointment-availability-and-wait-times-vary-considerably/https://www.tamarabeetham.com/publications/medicare-appointment-availability-and-wait-times-vary-considerably/We posed as new Medicare patients calling 444 primary care clinics across Chicago, Los Angeles, New York, and Portland to measure who could actually get an appointment. Acceptance ranged from 97% in Los Angeles to just 35% in Portland, with median wait times spanning 8 to 61 days. Larger multi-site practices and hospital-system-affiliated clinics were the least accessible, suggesting that consolidation may be reshaping primary care access in ways that warrant closer policy attention.Thu, 01 Jan 2026 00:00:00 GMT10.1093/haschl/qxag054Medicareprimary care accessaudit studysecret shopperhealth system consolidationwait timesindustrial organizationhealth services researchBeetham T, Marsh T, Barnett ML, Aaron RM, Greenberg E, Do Alexandra, Zhu JMhttps://www.tamarabeetham.com/publications/private-equity-acquisition-and-buprenorphine-prescribing/https://www.tamarabeetham.com/publications/private-equity-acquisition-and-buprenorphine-prescribing/Comparing 90 substance use disorder treatment facilities acquired by private equity to 2,374 non-acquired controls between 2019 and 2021, acquisition was associated with substantially higher buprenorphine patient volumes but with shorter treatment retention. Ninety-day retention fell about 6 percentage points and 180-day retention about 8 points after acquisition, suggesting that more patients may have started care but fewer remained in treatment long enough to meet retention benchmarks typically associated with clinical benefit.Thu, 01 Jan 2026 00:00:00 GMT10.1001/jamanetworkopen.2026.0250private equitybuprenorphinetreatment retentionsubstance use disorderindustrial organizationdifference-in-differencestreatment qualityhealth services researchHoldaway T, Busch SH, Reimer J, Beetham T, Fiellin DA, King Mhttps://www.tamarabeetham.com/publications/medicaid-increased-patient-access-to-moud-in-residential-treatment/https://www.tamarabeetham.com/publications/medicaid-increased-patient-access-to-moud-in-residential-treatment/After Medicaid Section 1115 waivers let states pay for residential addiction treatment, facilities in waiver states became 26 percentage points more likely to both accept Medicaid and offer FDA-approved opioid use disorder medications. Notably, nearly 90% of the access improvement came not from existing facilities changing their practices but from new facilities opening and others closing. Policy designs and evaluations that ignore market entry and exit may under- or over-predict their own effects.Wed, 01 Jan 2025 00:00:00 GMT10.1377/hlthaff.2025.00348MedicaidSection 1115 waiverMOUDresidential treatmentfacility entry and exitindustrial organizationdifference-in-differenceshealth policyBeetham T, Newton H, Ndumele C, Fiellin DA, Busch Shttps://www.tamarabeetham.com/publications/is-access-to-crisis-teams-associated-with-changes-in-behavioral/https://www.tamarabeetham.com/publications/is-access-to-crisis-teams-associated-with-changes-in-behavioral/Linking changes in county-level access to behavioral health crisis teams to changes in mortality from 2014 to 2019, crisis-team entry was associated with a 7% reduction in county drug overdose deaths, while crisis-team closure was associated with a 13% increase. Suicide and acute alcohol mortality showed no significant associations. The findings suggest crisis teams may be one lever for narrowing gaps in substance use treatment.Wed, 01 Jan 2025 00:00:00 GMT10.1093/haschl/qxaf003behavioral healthcrisis interventiondrug overdosefirst respondersmental health policycounty-level analysissubstance use disorder988 lifelineNewton H, Beetham T, Busch Shttps://www.tamarabeetham.com/publications/availability-of-medications-for-opioid-use-disorder-in-us-psychiatric/https://www.tamarabeetham.com/publications/availability-of-medications-for-opioid-use-disorder-in-us-psychiatric/This cross-sectional study examines whether US psychiatric hospitals, which frequently admit patients with co-occurring opioid use disorder, offer FDA-approved medications for that condition.Mon, 01 Jan 2024 00:00:00 GMT10.1001/jamanetworkopen.2024.44679psychiatric hospitalsMOUDopioid use disorderbehavioral health integrationinpatient careco-occurring disorderstreatment availabilityBeetham T*, Cohen SM*, Fiellin DA, Muvvala SBhttps://www.tamarabeetham.com/publications/access-to-treatment-before-and-after-medicare-coverage-of-opioid/https://www.tamarabeetham.com/publications/access-to-treatment-before-and-after-medicare-coverage-of-opioid/After Medicare began covering opioid treatment programs in 2020, the share of OTPs accepting Medicare jumped from 21% in 2018 to 81% by 2021. County-level access improved overall, with somewhat larger gains in counties with higher non-White populations. Availability of ancillary services such as HIV/AIDS education, employment services, and comprehensive mental health assessment did not increase, suggesting that Medicare coverage expanded enrollment access without expanding the underlying scope of services available to beneficiaries.Mon, 01 Jan 2024 00:00:00 GMT10.1093/haschl/qxae076Medicareopioid treatment programmethadoneOUD treatmenthealth equityancillary servicespolicy evaluationLiu R, Beetham T, Newton H, Busch Shttps://www.tamarabeetham.com/publications/adolescent-residential-addiction-treatment-in-the-us-uneven-access/https://www.tamarabeetham.com/publications/adolescent-residential-addiction-treatment-in-the-us-uneven-access/Posing as the aunt or uncle of a 16-year-old recovering from a non-fatal overdose, we called 160 US residential addiction facilities serving adolescents. Just over half had immediate beds; among the rest, the average waitlist was 28 days. Average daily cost was $878, with for-profit facilities charging roughly three times the nonprofit average. Half of facilities required up-front payment averaging $28,731. Ten states and DC had no identifiable adolescent residential treatment options at all.Mon, 01 Jan 2024 00:00:00 GMT10.1377/hlthaff.2023.00777adolescent addiction treatmentresidential treatmentwaitliststreatment costaudit studyfor-profit carehealth equitybehavioral healthKing C, Beetham T, Smith N, Englander H, Button D, Brown PCM, Hadland SE, Bagley SM, Wright OR, PT Korthuis, Cook Rhttps://www.tamarabeetham.com/publications/treatments-used-among-adolescent-residential-addiction-treatment/https://www.tamarabeetham.com/publications/treatments-used-among-adolescent-residential-addiction-treatment/This research letter surveys US adolescent residential addiction treatment facilities to assess which treatments, including FDA-approved medications for opioid use disorder, are offered to adolescents under 18.Sun, 01 Jan 2023 00:00:00 GMT10.1001/jama.2023.6266adolescent addiction treatmentresidential treatmentopioid use disorderMOUDtreatment patternsbehavioral healthKing C, Beetham T, Smith N, Englander H, Hadland SE, Bagley SM, PT Korthuishttps://www.tamarabeetham.com/publications/physician-response-to-covid-19-driven-telehealth-flexibility-for/https://www.tamarabeetham.com/publications/physician-response-to-covid-19-driven-telehealth-flexibility-for/Surveying 1,141 publicly registered buprenorphine prescribers in July 2020, telehealth use among physicians treating opioid use disorder more than doubled during the early pandemic (from 29% pre-COVID to 66%). Most found telehealth more effective than expected and 85% favored making the COVID-era flexibilities permanent. The findings indicate physician demand for the regulatory changes that have since informed national telehealth policy.Sat, 01 Jan 2022 00:00:00 GMT10.37765/ajmc.2022.89221telehealthbuprenorphinephysician surveyCOVID-19opioid use disorderregulatory policyDEAaccess to careBeetham T, Fiellin DA, Busch SHhttps://www.tamarabeetham.com/publications/association-of-access-to-crisis-intervention-teams-with-county/https://www.tamarabeetham.com/publications/association-of-access-to-crisis-intervention-teams-with-county/Before the launch of the 988 mental health crisis lifeline, we mapped county-level access to crisis intervention teams (trained behavioral health first responders) across 3,142 US counties. Although 88% of residents lived in a county with at least one CIT-equipped facility, half of all counties had none, and gaps concentrated in rural counties and in states without Medicaid expansion. Without targeted policy attention to these gaps, the lifeline's promise may go unrealized in the places where it is most needed.Sat, 01 Jan 2022 00:00:00 GMT10.1001/jamanetworkopen.2022.24803988 lifelinecrisis intervention teamsbehavioral health crisisrural healthMedicaid expansionfirst respondersmental health accessNewton H, Beetham T, Busch SHhttps://www.tamarabeetham.com/publications/admission-practices-and-cost-of-care-for-opioid-use-disorder-at/https://www.tamarabeetham.com/publications/admission-practices-and-cost-of-care-for-opioid-use-disorder-at/Posing as uninsured cash-paying individuals using heroin, we called 613 US residential addiction treatment programs. One-third of callers were offered admission before any clinical evaluation, often within a day. Up-front payments averaged over $17,000 at for-profit programs, roughly three times the nonprofit average, and aggressive recruitment practices were common, including at accredited and state-licensed facilities. The findings raise concerns that financially and clinically vulnerable patients may be routed into costly care without thorough clinical assessment of whether residential treatment is appropriate.Fri, 01 Jan 2021 00:00:00 GMT10.1377/hlthaff.2020.00378residential addiction treatmentaudit studysecret shopperfor-profit caretreatment costpatient brokeringconsumer protectionindustrial organizationBeetham T, Saloner B, Gaye M, Wakeman SE, Frank RG, Barnett Mhttps://www.tamarabeetham.com/publications/therapies-offered-at-residential-addiction-treatment-programs-in-the/https://www.tamarabeetham.com/publications/therapies-offered-at-residential-addiction-treatment-programs-in-the/Using simulated-patient calls to a random sample of US residential addiction facilities, this research letter examines which evidence-based treatments, such as buprenorphine-naloxone and nonpharmacologic therapies including CBT, are available for opioid use disorder, and how availability differs between for-profit and nonprofit centers.Wed, 01 Jan 2020 00:00:00 GMT10.1001/jama.2020.8969residential addiction treatmentMOUDbuprenorphineevidence-based treatmentfor-profit careaudit studytreatment qualityDATA WaiverBeetham T, Saloner B, Gaye M, Wakeman SE, Frank RG, Barnett Mhttps://www.tamarabeetham.com/publications/access-to-office-based-buprenorphine-treatment-in-areas-with-high/https://www.tamarabeetham.com/publications/access-to-office-based-buprenorphine-treatment-in-areas-with-high/Posing as uninsured or Medicaid-covered patients reporting active heroin use, we made 1,092 calls to 546 buprenorphine prescribers across six high-mortality jurisdictions. About half of Medicaid contacts were offered any new appointment, but only 27% were offered one with the possibility of starting buprenorphine at the first visit. Wait times when appointments were offered were short (median 6 days), suggesting existing prescribers may have additional capacity that current screening practices do not reach.Tue, 01 Jan 2019 00:00:00 GMT10.7326/M18-3457buprenorphineopioid use disorderaudit studysecret shopperMedicaidaccess to careDATA Waiverhealth policyBeetham T, Saloner B, Wakeman SE, Gaye M, Barnett Mhttps://www.tamarabeetham.com/publications/buprenorphine-prior-authorization-removal-low-hanging-fruit-in-the/https://www.tamarabeetham.com/publications/buprenorphine-prior-authorization-removal-low-hanging-fruit-in-the/A commentary arguing that one of the most underused policy levers in the opioid overdose crisis is the simplest: removing the prior-authorization requirements that delay buprenorphine access for patients who most need it.Tue, 01 Jan 2019 00:00:00 GMT10.54111/0001/Y2buprenorphineprior authorizationMedicaidOUD treatmentpolicy commentaryaddiction treatment accessBeetham Thttps://www.tamarabeetham.com/publications/deficits-in-visual-working-memory-capacity-and-general-cognition-in/https://www.tamarabeetham.com/publications/deficits-in-visual-working-memory-capacity-and-general-cognition-in/Comparing 79 patients with psychotic disorders to 166 controls (all African American), this study used Bayesian cognitive modeling to test whether the apparent visual working-memory deficit in psychosis is specific or part of a broader cognitive deficit. Reduced working-memory capacity was specific, exceeding what overall cognitive ability could explain, and partially mediated the broader cognitive deficit observed in psychosis.Mon, 01 Jan 2018 00:00:00 GMT10.1016/j.schres.2017.08.015psychosisschizophreniavisual working memorycognitive neuroscienceBayesian modelingneurocognitionMathias SR, Knowles EEM, Barrett J, Beetham T, Leach O, Buccheri S, Aberizk K, Blangero J, Poldrack RA, Glahn DChttps://www.tamarabeetham.com/publications/inferring-pathobiology-from-structural-mri-in-schizophrenia-and/https://www.tamarabeetham.com/publications/inferring-pathobiology-from-structural-mri-in-schizophrenia-and/Across 226 patients with schizophrenia, 227 with bipolar disorder, and 370 healthy controls scanned on the same MRI, head motion explained a substantial portion, though not all, of the structural brain differences typically attributed to these illnesses. After accounting for global cortical measures, regional specificity largely vanished, raising questions about whether structural MRI captures regionally specific pathology in psychotic and affective illness.Sun, 01 Jan 2017 00:00:00 GMT10.1002/hbm.23612schizophreniabipolar disorderstructural MRIhead motioncortical thicknessneuroimaging methodologyYao N, Winkler AM, Barrett J, Book GA, Beetham T, Horseman R, Leach O, Hodgson K, Knowles EM, Mathias S, Stevens MC, Assaf M, van Erp TGM, Pearlson GD, Glahn DChttps://www.tamarabeetham.com/publications/the-processing-speed-impairment-in-psychosis-is-more-than-just/https://www.tamarabeetham.com/publications/the-processing-speed-impairment-in-psychosis-is-more-than-just/Comparing 51 patients with psychotic illness to 90 IQ-matched controls (all African American) on a digit-symbol coding task analyzed via drift-diffusion modeling, this study tested whether the processing-speed deficit in psychosis is the same phenomenon as age-related slowing. It is not: psychosis lowered information-processing efficiency, while normal aging primarily increased response caution, indicating divergent cognitive mechanisms.Sun, 01 Jan 2017 00:00:00 GMT10.1093/schbul/sbw168psychosisschizophreniaprocessing speeddrift-diffusion modelBayesian inferencecognitive agingMathias SR, Knowles EM, Barrett J, Leach O, Buccheri S, Beetham T, Blangero J, Poldrack RA, Glahn DC