Pennsylvania Expands Opioid Centers of Excellence Initiative

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When working for the Pennsylvania Department of Drug and Alcohol Programs, Pinnacle’s Jason Snyder (right) traveled with Governor Tom Wolf to conduct roundtables on the opioid epidemic across the state. Later that year, Pinnacle’s Mt. Pocono Medical opioid treatment program was named a COE. Photo credit: Pocono Record, 2016

By Jason Snyder, Regional Director of Strategic Partnerships, Pinnacle Treatment Centers

If there was ever any question about the future of Pennsylvania’s opioid Centers of Excellence (COEs), the announcement that the program will be expanded well beyond the 45 facilities that exist today provides a resounding answer.

Gov. Tom Wolf’s administration developed the COE program in 2016 in response to the rapidly escalating opioid overdose death epidemic. Forty-five healthcare organizations, both behavioral and physical health providers, were selected to:

  1. Increase access to medication-assisted treatment (MAT);
  2. Coordinate physical and behavioral healthcare; and
  3. Keep individuals engaged in the recovery process along the full continuum of care through community-based care management.

What began as a grant program has moved into the Medicaid managed care system where COE care management services are reimbursed on a fee-for-service basis. Beginning Jan. 1, 2021, any addiction treatment or mental health services provider in Pennsylvania that successfully completes the application process and is designated as a COE can now participate in the program. That’s especially good news for individuals with opioid use disorder (OUD).

Pinnacle Treatment Centers and I are proud to have been pioneers of the commonwealth’s effort to move the addiction treatment system closer to evidence-based care and ensure that those who need treatment for OUD are able to quickly get it. I was privileged to work as special assistant to the secretary of the Department of Human Services when the COEs launched. My role was to support implementation and operation of the effort. Three of Pinnacle’s 13 Pennsylvania facilities  – Alliance Medical Services of Johnstown (Cambria County), Miners Medical (Luzerne County) and Mt. Pocono Medical (Monroe County) – were designated as COEs.

Today, nearly 1,000 total patients are receiving enhanced services through Pinnacle’s three COEs.

To achieve the three goals listed above, COEs essentially are charged with developing a recovery-oriented system of care in the communities they serve. At the time the COE program was being developed, we called this a hub-and-spoke model, with the COE as the hub and a variety of partners (e.g., primary care practices, criminal justice system, health systems) serving as the spokes. Patients come into the hub, are assessed and possibly treated there (depending upon the level of care they need) and are led out along the appropriate spokes to receive other necessary services. The model is similar to a medical home. But instead of a primary care physician coordinating all of the patient’s care, the COE is the “home” tasked with coordinating physical and behavioral health services for patients and ensuring those connections actually happen. Through a team approach that includes physicians, nurses, nurse practitioners, physician assistants, clinicians and peer support specialists, patients are provided evidence-based addiction treatment services, including MAT, guided and supported through the continuum of care and connected to other health and social services. The COE is, in effect, providing whole-person care.

All of Pinnacle’s Pennsylvania centers are opioid treatment programs (OTPs), and as such, we have always known from firsthand experience the power of MAT to transform individuals, families and communities with treatment that works. Research has always validated our treatment modalities. And now, the outcomes we and the other Pennsylvania COEs have produced serve as further proof that MAT saves lives and keeps people engaged in treatment longer. When that happens, the chances for sustained recovery from the disease of addiction are much greater.

One of the leading behavioral health managed care organizations in Pennsylvania closely tracks data from the 18 COEs in its network. Among other things, that data demonstrates that individuals who begin methadone maintenance treatment immediately upon entering the addiction treatment system have the highest retention rate among all COE patients in the 18 COE sample. More than 70 percent of those patients are still engaged in treatment at the six-month mark. Perhaps more telling is the fact that those who receive no medication have the lowest retention rates in treatment.

The future course of the COEs has been charted. That course is also a harbinger of where the entire addiction treatment system is headed – integrated, evidence-based care, including medication, that treats the whole person, not just the addiction.

If you have questions about the COE program or have a loved one in need of addiction treatment, please contact me.