The overlooked link between alcohol, heart health and Medicaid costs

The CDC reports that excessive alcohol use is responsible for more than 140,000 deaths each year in the United States and costs the nation an estimated $249 billion annually. Behind those numbers are families, communities and public programs working to manage the long-term impact of preventable illness.

For Florida’s Medicaid program, Alcohol Use Disorder (AUD) is closely tied to emergency department visits, repeat hospitalizations and long-term treatment for chronic conditions such as hypertension, stroke and heart disease. AUD can raise blood pressure and disrupt heart rhythms.

Over time, that strain on the heart can lead to serious and costly complications.

If we want to improve health outcomes and protect the long-term stability of Medicaid, we must intervene earlier.

Young people who begin drinking before age 15 are significantly more likely to develop AUD later in life. Early alcohol use is also linked to increased lifetime cardiovascular risk. The habits formed in adolescence and young adulthood can shape health outcomes for decades, often leading to patterns of chronic disease and high-cost care.

That makes youth prevention a fiscal and clinical priority for Medicaid. Managed care programs are structured to coordinate services, emphasize prevention and reduce avoidable hospital use. Early alcohol intervention fits squarely within that mission. When primary care providers routinely screen for alcohol use among youth and have a clear path for follow-up, risks can be identified sooner, and patients can be connected with support before complications escalate. Continued alignment between policymakers and health plans will be essential to expand routine screening, strengthen integrated behavioral health services and improve access to treatment before complications become costly.

Screening alone, however, isn’t enough. Care must be seamless when risk is identified. Strengthening coordination between behavioral health and primary care helps ensure patients don’t fall through the cracks. Expanding telehealth access in rural communities can reduce geographic barriers to care. Supporting medication-assisted treatment when clinically appropriate, with counseling and peer support, can improve long-term stability and reduce relapse risk.

Florida should continue strengthening integration between behavioral health and primary care to ensure seamless follow-up care when risk is identified. Expanding telehealth in rural communities, supporting medication-assisted treatment when clinically appropriate, and reducing barriers to behavioral health services will help prevent avoidable hospitalizations that strain families and the Medicaid system.

In rural counties where provider shortages limit specialty access, early intervention is especially critical to avoid high-cost hospital care.

Additionally, evidence-based medications for AUD remain underused nationwide, even though they improve outcomes. Improving appropriate access to these treatments is one of the clearest ways to reduce repeat hospitalization and improve cardiovascular health over time. Ensuring appropriate access to these treatments, alongside counseling and peer support, is essential to improving long-term outcomes and protecting Medicaid program sustainability.

Florida has made meaningful progress in strengthening managed care accountability. The next step is to elevate early alcohol intervention, particularly among adolescents and young adults, as a core Medicaid strategy for improving cardiovascular health and reducing preventable strain on the program.

AUD policy is heart policy. Acting earlier protects families, strengthens communities and supports the long-term sustainability of Florida’s health care system.

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Dr. Marc Kaprow, DO, is the Medical Director of Simply Healthcare.