James H Ford1, Amanda J Abraham2, Nicoleta Lupulescu-Mann3, Raina Croff4, Kim A Hoffman4, Kelly Alanis-Hirsch5, Mady Chalk6, Laura Schmidt7, Dennis McCarty4. 1. Center for Health Systems Research and Analysis, University of Wisconsin-Madison, Madison, Wisconsin. 2. Department of Public Administration and Policy, School of Public and International Affairs, University of Georgia, Athens, Georgia. 3. Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, Oregon. 4. OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon. 5. 2M Research Services, Raleigh-Durham, North Carolina. 6. The Chalk Group, Washington, D.C. 7. School of Medicine, University of California at San Francisco, San Francisco, California.
Abstract
OBJECTIVE: The Medication Research Partnership (MRP), a collaboration between a national commercial health plan and nine addiction treatment centers, implemented organizational and system changes to promote use of federally approved medications for treatment of alcohol and opioid use disorders. METHOD: A difference-in-differences analysis examined change over time in the percentage of patients receiving a prescription medication for alcohol or opioid use disorders treated in MRP (n = 9) and comparison (n = 15) sites. RESULTS: MRP clinics experienced a 2.4-fold increase in patients receiving an alcohol or opioid prescription (13.2% at baseline to 31.7% at 3 years after MRP initiation); comparison clinics experienced significantly less change (17.6% to 23.5%) with an adjusted difference-in-differences of 12.5% (95% CI [5.4, 19.6], p = .001). MRP sites increased the patients with prescriptions to treat opioid use disorder from 17.0% (baseline) to 36.8% (3 years after initiation), with smaller changes observed in comparison sites (23.2% to 24.0%) and a 3-year post-initiation adjusted difference-in-differences of 19% (95% CI [8.5, 29.5], p = .000). Medications for alcohol use disorders increased in both MRP (9.0% to 26.5%) and comparison sites (11.4% to 23.1%). CONCLUSIONS: Promoting the use of medications to support recovery required complex interventions. The Advancing Recovery System Change Model, initially developed in publicly funded systems of care, was successfully adapted for commercial sector use. The model provides a framework for providers and commercial health plans to collaborate and increase patient access to medications.
OBJECTIVE: The Medication Research Partnership (MRP), a collaboration between a national commercial health plan and nine addiction treatment centers, implemented organizational and system changes to promote use of federally approved medications for treatment of alcohol and opioid use disorders. METHOD: A difference-in-differences analysis examined change over time in the percentage of patients receiving a prescription medication for alcohol or opioid use disorders treated in MRP (n = 9) and comparison (n = 15) sites. RESULTS: MRP clinics experienced a 2.4-fold increase in patients receiving an alcohol or opioid prescription (13.2% at baseline to 31.7% at 3 years after MRP initiation); comparison clinics experienced significantly less change (17.6% to 23.5%) with an adjusted difference-in-differences of 12.5% (95% CI [5.4, 19.6], p = .001). MRP sites increased the patients with prescriptions to treat opioid use disorder from 17.0% (baseline) to 36.8% (3 years after initiation), with smaller changes observed in comparison sites (23.2% to 24.0%) and a 3-year post-initiation adjusted difference-in-differences of 19% (95% CI [8.5, 29.5], p = .000). Medications for alcohol use disorders increased in both MRP (9.0% to 26.5%) and comparison sites (11.4% to 23.1%). CONCLUSIONS: Promoting the use of medications to support recovery required complex interventions. The Advancing Recovery System Change Model, initially developed in publicly funded systems of care, was successfully adapted for commercial sector use. The model provides a framework for providers and commercial health plans to collaborate and increase patient access to medications.
Authors: Howard H Goldman; Richard G Frank; M Audrey Burnam; Haiden A Huskamp; M Susan Ridgely; Sharon-Lise T Normand; Alexander S Young; Colleen L Barry; Vanessa Azzone; Alisa B Busch; Susan T Azrin; Garrett Moran; Carolyn Lichtenstein; Margaret Blasinsky Journal: N Engl J Med Date: 2006-03-30 Impact factor: 91.245
Authors: Dennis McCarty; Nancy A Perrin; Carla A Green; Michael R Polen; Michael C Leo; Frances Lynch Journal: Drug Alcohol Depend Date: 2010-10-01 Impact factor: 4.492
Authors: Tami L Mark; Tracy Yee; Katharine R Levit; Jessica Camacho-Cook; Eli Cutler; Christopher D Carroll Journal: Health Aff (Millwood) Date: 2016-06-01 Impact factor: 6.301
Authors: K John McConnell; Samuel H N Gast; M Susan Ridgely; Neal Wallace; Natalie Jacuzzi; Traci Rieckmann; Bentson H McFarland; Dennis McCarty Journal: Am J Psychiatry Date: 2011-09-02 Impact factor: 18.112
Authors: Christopher T Rentsch; David A Fiellin; Kendall J Bryant; Amy C Justice; Janet P Tate Journal: Alcohol Clin Exp Res Date: 2019-02-03 Impact factor: 3.455
Authors: Raina Croff; Kim Hoffman; Kelly Alanis-Hirsch; Jay Ford; Dennis McCarty; Laura Schmidt Journal: J Behav Health Serv Res Date: 2019-04 Impact factor: 1.505
Authors: James H Ford; Arveen Kaur; Deepika Rao; Aaron Gilson; Daniel M Bolt; Helene Chokron Garneau; Lisa Saldana; Mark P McGovern Journal: Implement Res Pract Date: 2021-09-17
Authors: James H Ford; Deepika Rao; Aaron Gilson; Arveen Kaur; Helene Chokron Garneau; Lisa Saldana; Mark P McGovern Journal: J Dual Diagn Date: 2022-04-07
Authors: Helene Chokron Garneau; Mehret T Assefa; Booil Jo; James H Ford; Lisa Saldana; Mark P McGovern Journal: Psychiatr Serv Date: 2021-08-04 Impact factor: 3.084
Authors: James H Ford; Eric L Osborne; Mehret T Assefa; Amy M McIlvaine; Ahney M King; Kevin Campbell; Mark P McGovern Journal: BMC Health Serv Res Date: 2018-06-08 Impact factor: 2.655
Authors: Mehret T Assefa; James H Ford; Eric Osborne; Amy McIlvaine; Ahney King; Kevin Campbell; Booil Jo; Mark P McGovern Journal: BMC Health Serv Res Date: 2019-10-24 Impact factor: 2.655