- 2 million Americans are addicted to prescription opioids
- Opioid overdose is now the #1 cause of accidental death in America
- Opioid-related deaths have increased 200% since 2000
- Nearly 80% of people with opioid addiction do not receive treatment
- Wait lists for treatment can be a year long
Beacon’s Clinical Philosophy
Opioid addiction is a chronic brain disease, and should be managed and treated like any other chronic disorder. The historical abstinence-based model of care is often not effective in treating opioid addiction. An evidence-based, holistic treatment program should include medication, community support, and other recovery-oriented interventions.
Patient adherence to Medication-Assisted Treatment (MAT) reduces readmissions and all-cause mortality. MAT is an evidence-based treatment for opioid addiction; however, it is not a stand-alone treatment choice. It is highly effective as part of a holistic, evidence-based treatment program that includes behavioral, cognitive and other recovery-oriented interventions, treatment agreements, urine toxicology screens and utilization of prescription drug monitoring programs.
Beacon’s Opioid Pilot Programs
Beacon is executing a wide range of pilots and programs to follow through on our commitments in the opioid white paper, “Confronting the Crisis of Opioid Addiction,” and address this urgent public health crisis. Beacon’s programs range from clinical pilots to value-based payment creation to educational initiatives.
Many of these pilots are locally based and early stage; we are committed to continuing to expand our impact and sharing information with all stakeholders as we learn more.
Challenge: Patients avoid inpatient detox because they can’t leave their jobs or communities.
Beacon’s Treatment Solution: Expand community-based withdrawal management.
Partnering with a leading community health center in Northeast Massachusetts, Beacon is pursuing a pilot program to provide outpatient withdrawal management with direct linkages to primary care for buprenorphine (MAT) treatment. In another market, we have contracted with a transportation company to help members get to OP MAT as transportation is often a barrier to engagement. Community-based withdrawal management is an evidence-based treatment that expands access to services, especially for those members who cannot leave their jobs, communities or families.
Challenge: Patients quit 24-hour care, preventing engagement in long-term treatment.
Beacon’s Treatment Solution: Reduce early discharges.
The National Institute on Drug Abuse reports that individuals who leave treatment prematurely have less favorable outcomes than those who continue treatment. In 2015, Beacon completed a pilot in Pennsylvania to help providers prevent early discharges from residential facilities, including facility-led interventions and best-practice sharing between facilities; a significant reduction in early discharges was accomplished.
Challenge: Discharged patients do not adhere to treatment.
Beacon’s Treatment Solution: Community support to improve treatment adherence.
In this pilot, we use Community Support Programs (CSPs) to help ensure care continuity for members discharging from withdrawal management. CSPs often include peers with lived experience who meet members discharging from withdrawal management and help connect them to aftercare, transportation and community resources.
Challenge: Patients treated via an abstinence model combat cravings and often relapse.
Beacon’s Treatment Solution: Change care pathways from withdrawal management directly to MAT.
This pilot fosters timely connections between ATS (withdrawal management) and outpatient MAT providers. Members are not detoxed to zero, but instead connected to MAT treatment the day after discharge from ATS, minimizing the risk of relapse. The pilot promotes Beacon’s view that MAT is a key tool for successful recovery.
Challenge: MAT treatment slots are not available due to provider shortage.
Beacon’s Treatment Solution: Alternative payment models.
This project aims to expand MAT and community-based capacity by aligning provider financial incentives with clinical outcomes. Beacon is working to develop a standardized bundled payment for buprenorphine treatment with several providers, as well as developing an opioid treatment episode bundle.
Challenge: Patients struggle with MAT treatment adherence.
Beacon’s Treatment Solution: Intensive Care Management (ICM) for MAT.
Beacon is partnering with methadone treatment providers and leveraging intensive case management to help improve methadone maintenance adherence. Improved adherence has been shown to reduce inpatient readmissions and mortality for these members.
Challenge: The historic addiction model of care is slow to learn and adapt.
Beacon’s Treatment Solution: Educational initiatives.
Beacon educates members and providers on best practices in caring for an opioid use disorder, including web-based information about the national opioid epidemic, treatment options, and resources as well as an Opioid Toolkit for providers.