A Financial Model for Team-Based Opioid Use Disorder Treatment.
INTRODUCTION
Opioid use disorder (OUD) affects 2 million Americans, yet many patients do not receive treatment. Lack of team-based care is a common barrier for office-based opioid treatment (OBOT). In 2015, we started OBOT in a family medicine practice. Based on our experiences, we developed a financial model for hiring a team member to provide nonbillable OBOT services through revenue from increased patient volume.


METHODS
We completed a retrospective chart review from July 2015 to December 2016 to determine the average difference in medical visits per patient per month pre-OBOT versus post-OBOT. Secondary outcomes were the percentage of visits coded as a Level 3, Level 4, and Level 5, and the percentage of patients with Medicaid, private insurance, or self pay. With this information, we extrapolated to build a financial model to hire a team member to support OBOT.


RESULTS
Twenty-three patients received OBOT during the study period. There was a net increase of 1.93 visits per patient per month (P < .001). Fourteen patients were insured by Medicaid, 7 had private insurance, and 2 were self pay. Twenty-three percent of OBOT visits were Level 3, 69% were Level 4, and 8% were Level 5. Assuming all visits were reimbursed by Medicaid and accounting for 20% cost of business, treating 1 existing patient for 1 year would generate $1,439. Treating 1 new patient would generate $1,677.


CONCLUSIONS
In a fee-for-service model, the revenue generated from increased medical visits can offset the cost of hiring a team member to support nonbillable OBOT services.
['Farrar|Mackenzie|M|', 'White|Zach|Z|', 'Hulkower|Stephen|S|', 'Fagan|E Blake|EB|', 'Wilson|Courtenay Gilmore|CG|']
D002047:Buprenorphine D005194:Family Practice D018588:Fee-for-Service Plans D006801:Humans D009292:Narcotic Antagonists D058850:Opiate Substitution Treatment D009293:Opioid-Related Disorders D012189:Retrospective Studies
Opioids Medicaid Buprenorphine Fee-for-Service Plans Opioid-Related Disorders Retrospective Studies