Name
Reforming the Care Model for Opioid Use Disorder (OUD) Treatment
Date
Friday, November 1, 2024
Track
Value-based Care
Description

Since its founding, Groups Recover Together has reshaped how addiction treatment is delivered and reimbursed in the United States. Approximately 70% of Groups Recover Together's membership is covered by Medicaid, and around 93% of its revenue comes from value-based contracts, where reimbursement is tied to recovery outcomes rather than the volume of services provided.

In 2023, Groups Recover Together helped 27,027 members across 13 states achieve their recovery goals. They established 43 new contracts with health plans, 38 of which were value-based, expanding access to Groups treatment to 23.6 million new individuals with in-network insurance coverage. The organization supported six-month retention rates that were three times the national benchmark and achieved toxicology-confirmed opioid remission at twice the national benchmark. Additionally, they improved members' quality of life by an average of 32% in areas such as physical health, mental health, sleep quality, and social relationships, and reduced the total cost of care for health plan partners by 37%.

This presentation will detail these results and, where possible, provide industry benchmarks for context. The results will be organized according to the Cascade of Care framework for responding to the opioid overdose epidemic. This public health framework examines how effectively the demand for OUD treatment translates into appropriate, evidence-based treatment supply and ultimately impacts the population.

You Will Learn:

  • The impact of value-based contracts on treatment outcomes and reimbursement
  • The success metrics for recovery goals, retention rates, and opioid remission
  • Improvements in quality of life for members in various aspects such as physical and mental health
  • The reduction in total cost of care for health plan partners
  • Industry benchmarks for comparing treatment outcomes and efficiency.
Jacob Crothers, MD