Title Pending 6418

This is an accepted article with a DOI pre-assigned that is not yet published.Background: The US Preventive Services Taskforce recommends one-time Hepatitis C (HCV) screening for all adults and periodic screening for high-risk individuals. Though HCV treatments are available with cure rates of about 95%, it is estimated that more than one-half of HCV cases are undiagnosed and only one-third of HCV patients receive treatment. This research sought to understand the gaps in HCV screening and treatment by examining geographic variation within Ohio. Methods: Using county-level data from the Ohio Integrated Behavioral Health Dashboard, we used geospatial analysis to map the percentage of Medicaid enrollees ages 18-64 with opioid use disorder (OUD) that were screened and treated for HCV. Health care capacity and other risk factors were also compared by high and low HCV screening and treatment counties. Results: Our analysis showed geographic disparities for HCV screening and treatment. Southwestern Ohio has significantly higher screening rates compared to northeastern Ohio. High screening counties have significantly more health center testing sites compared to low screening rate counties. Northeastern Ohio had significantly higher rates of HCV treatment despite lower screening rates. High treatment counties were more likely to be in non-metropolitan areas and have fewer health care resources, including significantly fewer HCV physician specialists and primary care physicians (PCPs). Conclusion: We found wide disparities across Ohio in screening and treatment for HCV. Removing these disparities is necessary to eliminate HCV. We found that better access to health centers and PCPs may improve screening rates, but were not associated with increased treatment.