We are experiencing the deadliest drug overdose crisis in our country’s history, and we know that unique and innovative approaches are critical to effectively combatting the opioid epidemic.
December 20, 2017
Allegheny Health Network (AHN) announced today that it has established a medication-assisted opioid treatment program that is part of a new, hub-and-spoke model of care aimed at reaching more patients with opioid use disorder. The program, to be progressively implemented over the next year, is supported by a $1 million grant that has been awarded to only three other medical institutions in Pennsylvania. Together, the institutions form the Pennsylvania Coordinated Medication-Assisted Treatment (PacMAT) program.
The hub of the new program, located at Allegheny General Hospital, is led by Mitchell West, DO, Director of Addiction Medicine at AHN, who will oversee a multidisciplinary staff including an addiction psychiatrist, behavioral health specialist, pharmacist, clinical educator, and more. The hub staff will provide clinical leadership to the spokes which include 10 primary care sites throughout Western Pennsylvania. Each site will be equipped to provide high quality Medication-Assisted Treatment (MAT) as defined by the American Society of Addiction Medicine’s practice guidelines. MAT combines medication with onsite behavioral therapy to reduce urges and withdrawal symptoms.
To provide ongoing support to the spokes, as well as health care providers in rural areas who are caring for patients with opioid use disorder, the hub staff will utilize telemedicine technology to provide education, expert consultation, and operational assistance. Both the hub and spokes will be closely connected to many of the region’s licensed drug and alcohol treatment facilities, single county authorities, behavioral health providers, and social services which can address patients at all stages of recovery.
“We are experiencing the deadliest drug overdose crisis in our country’s history, and we know that unique and innovative approaches are critical to effectively combatting the opioid epidemic. This new model of care reaches patients in the communities they live, wrapping them with a range of evidence-based therapies and services – all of which is supported by a team of leading experts in addiction medicine,” said Dr. West.
In addition to the integration of MAT into multiple primary care sites across AHN, enhanced pain management centers will be piloted at AHN’s West Penn Hospital, Forbes Hospital, and Wexford Health + Wellness Pavilion. The pain centers will host integrated, multidisciplinary teams that can address chronic pain in the setting of addiction, mental illness and opioid dependence. The goals of the centers will be to reduce opioid prescribing for chronic pain, replace opioids with effective treatment modalities for pain management such as acupuncture and massage therapy, and address issues of opioid use disorder and substance use disorder in patients suffering from pain.
Finally, for those who arrive at an AHN emergency department following an overdose, the hub staff will work to develop pathways for stabilization of these patients, including initiation of an effective opioid replacement therapy such as buprenorphine, followed by more rapid handoffs to treatment.
“It has been estimated that more than half of overdose patients who are revived with naloxone and then treated at an emergency department leave against medical advice,” said Dr. West. “It is our goal to begin routinely administering in the emergency department a replacement therapy which treats symptoms of withdrawal, providing a greater opportunity to bridge the patient to community-based MAT and/or other recovery services. In this way, a patient’s life-threatening event can quickly transition to the beginning of recovery. ”
In August, AHN announced its Center of Excellence for Opioid Use Disorder. This comprehensive program helps Medicaid patients with opioid-related substance use disorders receive the health and community-based care and support they need to overcome addiction and maintain long-term wellness.
“Through our Center of Excellence (COE) for Opioid Use Disorder, 340 patients have been connected with MAT or other recovery services,” said Stuart Fisk, CRNP, Director, AHN Center for Inclusion Health. “These new programs and services are a natural extension of the COE model and will help us to serve a broader population including patients who are uninsured, underinsured and privately insured.”
According to Charles DeShazer, MD, Senior Vice President and Chief Medical Officer at Highmark Blue Cross Blue Shield, Highmark is committed to creating sustainable payment models following the terms of the grant to support the continued fight against the opioid epidemic.
“Our entire enterprise has made significant investments in a range of opioid addiction support services to guide our members to recovery,” said Dr. DeShazer. “Combined with AHN’s clinical expertise in addiction medicine, AHN and Highmark are poised to be able to address the opioid epidemic in a significant way for the benefit of our members, patients and families throughout Western Pennsylvania.”
The grant is funded through the 21st Century Cures grant, a $26.5 million federal grant received by the Wolf Administration to combat the heroin and opioid epidemic by increasing access to treatment, reducing unmet treatment need, and reducing opioid overdose-related deaths through the provision of prevention, treatment and recovery activities for opioid use disorder. According to the Wolf Administration, 23 organizations applied.
About the Allegheny Health Network
Allegheny Health Network (http://www.AHN.org), a Highmark Health company, is an integrated healthcare system serving the greater Western Pennsylvania region. The Network is composed of eight hospitals, including Allegheny General Hospital, its flagship academic medical center in Pittsburgh, Allegheny Valley Hospital in Natrona Heights, Canonsburg Hospital in Canonsburg, Forbes Hospital in Monroeville, Jefferson Hospital in Jefferson Hills, Saint Vincent Hospital in Erie, West Penn Hospital in Pittsburgh and Westfield Memorial Hospital in Westfield, NY. The Network provides patients with access to a complete spectrum of advanced medical services, including nationally recognized programs for primary and emergency care, cardiovascular disease, cancer care, orthopedic surgery, neurology and neurosurgery, women’s health, diabetes and more. It also is home to a comprehensive research institute; Health + Wellness Pavilions; an employed physician organization, home and community based health services and a group purchasing organization. The Network employs approximately 17,000 people, has more than 2,800 physicians on its medical staff and serves as a clinical campus for Drexel University College of Medicine, Temple University School of Medicine, and the Lake Erie College of Osteopathic Medicine.
About Highmark Health
Highmark Health, a Pittsburgh, PA based enterprise that employs more than 40,000 people nationwide and serves nearly 50 million Americans in all 50 states, is the second largest integrated health care delivery and financing network in the nation based on revenue. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to more than 5 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, Davis Vision and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, more than 2,800 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms. To learn more, please visit http://www.highmarkhealth.org.