A telemedicine bridge clinic improves access and reduces cost for opioid use disorder care
Objective: We evaluated the impact of a telemedicine bridge clinic on treatment outcomes and cost for patients with opioid use disorder. Telemedicine bridge clinics deliver low-barrier rapid assessment of patients with opioid use disorder via audio-only and audiovisual telemedicine to facilitate ind...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Drug and Alcohol Dependence Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772724624000118 |
| _version_ | 1797249061832622080 |
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| author | Michael J. Lynch Dominic Vargas Mary E. Winger Justin Kanter Jessica Meyers James Schuster Donald M. Yealy |
| author_facet | Michael J. Lynch Dominic Vargas Mary E. Winger Justin Kanter Jessica Meyers James Schuster Donald M. Yealy |
| author_sort | Michael J. Lynch |
| collection | DOAJ |
| description | Objective: We evaluated the impact of a telemedicine bridge clinic on treatment outcomes and cost for patients with opioid use disorder. Telemedicine bridge clinics deliver low-barrier rapid assessment of patients with opioid use disorder via audio-only and audiovisual telemedicine to facilitate induction on medication therapy and connection to ongoing care. Methods: A pre-post analysis of UPMC Health Plan member claims was performed to evaluate the impact of this intervention on the trajectory of care for patients with continuous coverage before and after bridge clinic visit(s). Results: Analysis included 150 UPMC Health Plan members evaluated at the bridge clinic between April 2020 and October 2021. At least one buprenorphine prescription was filled within 30 days by 91% of patients; median proportion of days covered by buprenorphine was 73.3%, 54.4%, and 50.6% at 30, 90, and 180 days after an initial visit compared to median of no buprenorphine claims 30 days prior among the same patients. Patients had an 18% decline in unplanned care utilization 30 days after initial Bridge Clinic visit, with a 62% reduction in unplanned care cost per member per month (PMPM), 38% reduction in medical cost PMPM, and 10% reduction in total PMPM (medical + pharmacy cost) at 180 days. Primary care, outpatient behavioral health, and laboratory costs increased while emergency department, urgent care, and inpatient costs declined. Conclusion: Utilization of a telemedicine bridge clinic was associated with buprenorphine initiation, linkage to ongoing care with retention including medication treatment, reduced unplanned care cost, and overall savings. |
| first_indexed | 2024-04-24T20:24:30Z |
| format | Article |
| id | doaj.art-1769bde1bbe3488a89f49b94fc94e98e |
| institution | Directory Open Access Journal |
| issn | 2772-7246 |
| language | English |
| last_indexed | 2024-04-24T20:24:30Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj.art-1769bde1bbe3488a89f49b94fc94e98e2024-03-22T05:41:19ZengElsevierDrug and Alcohol Dependence Reports2772-72462024-06-0111100227A telemedicine bridge clinic improves access and reduces cost for opioid use disorder careMichael J. Lynch0Dominic Vargas1Mary E. Winger2Justin Kanter3Jessica Meyers4James Schuster5Donald M. Yealy6UPMC Health Plan, USA; UPMC Department of Emergency Medicine, University of Pittsburgh, USA; Correspondence to: UPMC Department of Emergency Medicine, University of Pittsburgh, 3600 Forbes at Meyran Avenue Forbes Tower, Suite 400A, Pittsburgh, PA 15213, USAUPMC Health Plan, USAUPMC Health Plan, USAUPMC Center for High-Value Health Care, USAUPMC Center for High-Value Health Care, USAUPMC Health Plan, USAUPMC Department of Emergency Medicine, University of Pittsburgh, USAObjective: We evaluated the impact of a telemedicine bridge clinic on treatment outcomes and cost for patients with opioid use disorder. Telemedicine bridge clinics deliver low-barrier rapid assessment of patients with opioid use disorder via audio-only and audiovisual telemedicine to facilitate induction on medication therapy and connection to ongoing care. Methods: A pre-post analysis of UPMC Health Plan member claims was performed to evaluate the impact of this intervention on the trajectory of care for patients with continuous coverage before and after bridge clinic visit(s). Results: Analysis included 150 UPMC Health Plan members evaluated at the bridge clinic between April 2020 and October 2021. At least one buprenorphine prescription was filled within 30 days by 91% of patients; median proportion of days covered by buprenorphine was 73.3%, 54.4%, and 50.6% at 30, 90, and 180 days after an initial visit compared to median of no buprenorphine claims 30 days prior among the same patients. Patients had an 18% decline in unplanned care utilization 30 days after initial Bridge Clinic visit, with a 62% reduction in unplanned care cost per member per month (PMPM), 38% reduction in medical cost PMPM, and 10% reduction in total PMPM (medical + pharmacy cost) at 180 days. Primary care, outpatient behavioral health, and laboratory costs increased while emergency department, urgent care, and inpatient costs declined. Conclusion: Utilization of a telemedicine bridge clinic was associated with buprenorphine initiation, linkage to ongoing care with retention including medication treatment, reduced unplanned care cost, and overall savings.http://www.sciencedirect.com/science/article/pii/S2772724624000118TelemedicineBridge clinicBuprenorphineOpioid use disorder |
| spellingShingle | Michael J. Lynch Dominic Vargas Mary E. Winger Justin Kanter Jessica Meyers James Schuster Donald M. Yealy A telemedicine bridge clinic improves access and reduces cost for opioid use disorder care Drug and Alcohol Dependence Reports Telemedicine Bridge clinic Buprenorphine Opioid use disorder |
| title | A telemedicine bridge clinic improves access and reduces cost for opioid use disorder care |
| title_full | A telemedicine bridge clinic improves access and reduces cost for opioid use disorder care |
| title_fullStr | A telemedicine bridge clinic improves access and reduces cost for opioid use disorder care |
| title_full_unstemmed | A telemedicine bridge clinic improves access and reduces cost for opioid use disorder care |
| title_short | A telemedicine bridge clinic improves access and reduces cost for opioid use disorder care |
| title_sort | telemedicine bridge clinic improves access and reduces cost for opioid use disorder care |
| topic | Telemedicine Bridge clinic Buprenorphine Opioid use disorder |
| url | http://www.sciencedirect.com/science/article/pii/S2772724624000118 |
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