- A population health management program in Nashua, New Hampshire that focuses on care coordination for substance abuse patients has reduced overdoses and fatalities in the region by 34 percent while saving nearly $2 million in utilization costs.
The initiative turns fire stations into safe havens for individuals seeking help for substance abuse – and particularly opioid abuse – allowing patients at risk of significant harm to access services within their communities. Seven fire states are currently participating in the program.
The program stresses that patients pursuing help will not be identified to law enforcement authorities. If the individual does not need to visit the emergency department for immediate treatment after a comprehensive assessment, they are referred to a substance treatment center or residential shelter.
Each site in the Safe Station project is equipped with the ClientTrack care coordination platform, which allows trained representatives to enroll the patient in a comprehensive community population health management program called the Partnership for Successful Living.
Since November of 2016, the initiative has reduced overdoses and deaths from substance abuse by more than a third compared to data from 2015. The community has also saved $1.9 million in emergency department costs.
“The Safe Station program is an important component to addressing substance use disorders in Southern New Hampshire,” said Samantha Cassista Quality Improvement Specialist at Harbor Homes, one of the six members of the Partnership. Harbor Homes offers a full suite of patient care services, including clinical care, medical assisted treatment, behavioral healthcare, and services for the homeless.
“Coordinating multiple agencies that are providing diverse services for low-income individuals is not only complex, but there are unique challenges for integrated care,” Cassista added. “The results seen thus far in the program reflect an immediate community-wide cost savings stemming from fewer emergency room visits, and, more importantly, a reduction in overdose-related fatalities.”
Ninety-seven percent of individuals who enroll in care coordination services through the Safe Station program are evaluated by a Licensed Alcohol and Drug Counselor, the organization says.
Eighty percent end up utilizing at least one service from the Partnership for Successful Living, including primary care, behavioral health, and workforce development opportunities. More than 200 Nashua-area residents have taken advantage of the program so far.
State policymakers are desperately seeking innovative strategies for addressing the growing opioid crisis, which takes tens of thousands of lives across the country each year. More than 50,000 people died in 2016 alone from opioid addiction.
Deaths attributed to opioid misuse have quadrupled since 1999, said a Surgeon General report from late in 2016, producing “devastating” impacts on communities nationwide. Many patients start taking legally prescribed opioids for legitimate pain, but are unable to wean themselves off the medication due to provider mismanagement of their conditions.
“Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely,” wrote Surgeon General Vivek H. Murthy, MD, MBA. “This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.”
“I know solving this problem will not be easy. We often struggle to balance reducing our patients’ pain with increasing their risk of opioid addiction. But, as clinicians, we have the unique power to help end this epidemic. As cynical as times may seem, the public still looks to our profession for hope during difficult moments. This is one of those times.”
CMS and other key policymakers have urged healthcare providers to embrace patient-centered population health management and care coordination strategies to attack opioid abuse at its roots, and have also advocated for more involvement from public health organizations to deliver emergency overdose treatments to patients.
“CMS wants beneficiaries, their families, and caregivers to know what opioids are, the risk associated with their use and the role opioids may play in pain management,” the agency said in a blog post earlier this year.
“Our primary aim is to ensure that patients, their families, and caregivers have a better understanding of how to work with providers to identify treatment goals and successfully manage pain using current, safe, effective, and accessible treatments; for many patients this may not include an opioid.”
Health IT tools are playing a critical role in connecting patients with resources, reducing drug-seeking behavior, and enabling providers to better understand patterns of substance misuse within their communities.
From state Prescription Drug Management Programs (PDMPs) to mHealth and telemedicine tools that educate patients and enable communication with providers, communities are investing in a variety of data-driven infrastructure to enhance their ability to track, intervene, and follow-up with high-risk patients.
The Safe Stations program is a positive illustration of how to coordinate care across a complex region.
“Nashua is leading the way for communities seeking innovative solutions to end the opioid crisis,” said Carl Champagne, CEO of Eccovia Solutions, which provides the care coordination platform to member organizations.
“The Safe Station program is an example of how ClientTrack can help with care coordination across agencies to provide integrated primary, behavioral care and peer support services to address whole-person care.”