A recent McKinsey and Co. study suggests the nationwide prevalence of opioid use disorder (OUD) could be upwards of four to six million people, significantly higher than government estimates. And despite progress toward increasing addiction treatment access, only 25% of those with OUD receive any kind of treatment and only half of those are still in treatment at six months.
Although there are many different approaches to addiction treatment, a substantial body of evidence has shown that medication-assisted treatment (MAT) is the gold standard for treating patients with OUD.
However, expanding access to MAT requires overcoming many challenges. We spoke with providers and patients across the US to learn about these barriers, and their answers underscore the low rates of MAT enrollment and adherence.
Stigma is defined as a strong lack of respect for a person or group of people or a bad opinion about them because they have done something society does not approve of. Some still consider addiction a moral failure or character flaw rather than a chronic disease like asthma or diabetes, and that perception can prevent individuals from seeking and completing addiction treatment.
Lack of Provider Buy-In
Stigma about addiction persists throughout the medical profession. Whether a doctor doesn’t think it’s their job to administer MAT or believes perception of their practice will change if they start prescribing buprenorphine, biases against MAT in the provider setting has led to a lack of provider support and continues to serve as a barrier to treatment. Not only does it affect a provider’s willingness to treat patients with OUD, contributing to the access issue, it can also stop individuals from seeking healthcare altogether.
Lack of Provider Training & Time
It’s no surprise that providers want to feel confident in the care they provide their patients. And with a lack of medical school training on addiction and its complex treatment, many primary care providers are wary of providing MAT care. Providers can get certified to treat patients with MAT by completing eight hours of additional training and applying for a buprenorphine waiver, but that requires finding the time for a day’s worth of work in an already busy schedule.
A hectic schedule not only affects a provider’s ability to apply for a waiver but also their ability to treat patients at their waiver capacity. In a recent study, not having time for more patients was the single, most cited reason for not prescribing to capacity, while receiving more information about local counseling resources, being paired with an experienced physician, and more CME courses for OUD were listed as the three priorities most likely to increase their willingness to prescribe to capacity. Without medical schools incorporating addiction treatment in their curricula or additional support outside of school, a lack of training will continue to prevent access to care.
Although there are thousands of addiction recovery centers across the US, identifying high-quality, affordable MAT care is not only difficult for patients searching for treatment, but also health plans striving to build quality networks and connect members to care. Without measures that link a provider’s adherence to evidence-based addiction treatment with patient health outcomes, expanding access to high quality care will remain an obstacle.
When it comes to addiction treatment, a wait list of any kind impacts the opportunity for recovery. Because of burdensome credentialing and reimbursement processes, many MAT providers have chosen to be cash-only clinics. When you couple a shortage of providers taking insurance with waiver limits regulating how many patients can be treated, patient access is significantly impacted.
Building an effective MAT network requires pinpointing access gaps by understanding where members diagnosed with or at risk for OUD exist and overlaying that with MAT provider network intelligence. Up-to-date information, such as a provider’s buprenorphine waiver counts, is critical to patient referral and successful initiation of treatment.
At axialHealthcare, we use advanced analytics to stratify providers on key performance indicators that highlight quality and access gaps. We use this information to enable better network decisions so members in need of treatment can get the care they need, regardless of their location.
Is MAT access and quality a challenge for your organization? Let’s find a time to connect.