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Opioid Health Homes

Under the Affordable Care Act, three states implemented Opioid Health Homes, systems designed to coordinate and improve treatment for opioid use disorder 

Under provisions of the Affordable Care Act, three states (Maryland, Rhode Island, and Vermont) implemented Opioid Health Homes (OHHs), systems designed to coordinate care for individuals with opioid use disorder (OUD). Components of care included all forms of medications for opioid use disorder (MOUD), medical and behavioral health care, and services to address the social determinants of health.

Research into these state's implementation of the OHH suggest that contextual factors influenced the extent and nature of care coordination, but that, overall, service delivery improved by virtue of increased integration across modalities and providers. Factors responsible for successful implementation, as well as barriers, were identified in a three state study and a CMS issue brief, and the University of Kentucky College of Law has made available a detailed report on how OHHs can be instituted.  

The Opioid Health Home model has the potential to meet complex needs of disadvantaged patients.

Continuum of Care
Treatment
Recovery
Type of Evidence
Peer-reviewed
Replicated
Response Approach
Comprehensive services
Housing, Education, and Employment
Medications for Opioid Use Disorder
Peer-reviewed Article
Experiences of Three States Implementing the Medicaid Health Home Model to Address Opioid Use Disorder—Case Studies in Maryland, Rhode Island, and Vermont
Related Resources
Integrating Substance Use Disorder Treatment and Primary Care
Integrating Public Health and Health Care Strategies to Address the Opioid Epidemic: The Oregon Health Authority’s Opioid Initiative
The Intersection of Hepatitis, HIV, and the Opioid Crisis: The Need for a Comprehensive Response
Integrated Prevention Services for HIV Infection, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis for Persons Who Use Drugs Illicitly
The Role of Community Health Centers in Addressing the Opioid Epidemic
Designing Medicaid Health Homes for Individuals with Opioid Dependency: Considerations for States
Opioid Use Disorder: Barriers to Medicaid Beneficiaries’ Access to Treatment Medications
Using Medicaid to Advance Evidence-Based Treatment of Substance Use Disorders: A Toolkit for State Medicaid Leaders

Evidence of Program Effectiveness

"Overall, discussants reported that the OHH model was implemented successfully and was responsible for substantial improvements in patient care. Contextual factors at both the state level (e.g., legislation, funding, state leadership, program design) and provider level (OHH provider characteristics, leadership, adaptability) affected each stage of implementation of the OHH model. States took a variety of approaches in designing and implementing the model, with facilitators related to gathering stakeholder input, receiving guidance and technical assistance, and tailoring program design to build on the state's existing care coordination initiatives and provider infrastructure. The OHH model constituted a substantial change for almost all OHH providers in the study, who reported that facilitators to implementation included having goals and workplace culture that were compatible with the OHH model, and having technical support from the state or non-governmental organizations." (Clemans-Cope et al., 2017)