A virtual-first telehealth treatment model for opioid use disorder

The multi-decade opioid crisis in the US has cost the nation greatly in terms of
lives lost and many billions of dollars spent. Although FDA-approved medications for OUD (MOUD, also referred to as medication-assisted treatment [MAT]) are the most clinically and cost effective form of treatment for OUD, they remain widely underutilized. Among the estimated 7.6 million individuals with OUD in the US, fewer than 20% receive this evidence based treatment due to myriad barriers.

By addressing key barriers to access and retention that affect in-person MAT, high-quality telehealth platforms like Ophelia are able to improve outcomes and reduce costs at the population level. Ophelia is a virtual-first provider of evidence-based
telehealth OUD treatment with buprenorphine, committed to making quality OUD care universally accessible. Our mission is to remove barriers for the 80% of Americans with OUD who are unable to access care and the 50,000+ X-waivered clinicians who are unable to treat patients due to a lack of infrastructure, training, and support. At its core is the Ophelia Care Model, a team-based clinical model emphasizing coordinated and collaborative care developed by leading experts in addiction medicine and psychiatry, and a best-in-class software platform.

To be most effective in improving health outcomes and reducing associated costs, MAT requires long-term, accessible outpatient care that incorporates medication management and ancillary services such as care coordination and wraparound services for commonly occurring comorbid conditions. Recognizing the efficacy
and cost-savings associated with these ancillary services, the Centers for Medicare and Medicaid Services (CMS) recently created a reimbursement framework that allows bundled payment, creating a standard that insurers can model for telehealth services. By encouraging long-term treatment with high-quality telehealth-based MAT providers and incentivizing effective and comprehensive care via bundled payments, insurers have a compelling opportunity to help combat the ongoing opioid crisis while also reducing the substantial costs associated with untreated and undertreated OUD.