Blue Cross to launch new medication-assisted treatment program

Blue Cross Blue Shield of Michigan is launching a new multipronged program to help people with substance use disorder get the treatment they need. The MAT Practice Transformation Program, which centers around medication-assisted treatment, or MAT, was announced at the Sept. 20, 2019, Physician Group Incentive Program meeting. It launches Jan. 1, 2020.

MAT is the use of medications, in combination with counseling and behavioral therapies, to provide a holistic approach to the treatment of substance use disorders. Research has shown it can be very effective in treating opioid use disorders and helping prevent relapses.

The new MAT program has three main components:

1. Improving access to treatment. Working with the Michigan Opioid Collaborative, we’re helping more primary care physicians obtain training to prescribe buprenorphine, one of the medications used to treat patients fighting addiction. The MOC is a Michigan Medicine initiative that was formed in partnership with the Michigan Department of Health and Human Services. We’ll be providing incentives to encourage providers to obtain training and offer patients MAT services.
2. Developing care teams to support patients battling opioid use disorder. Working with the Michigan Institute for Care Management and Transformation and our physician organizations, we’ll be developing care management teams within practices, including nurses, pharmacists, social workers and behavioral health specialists, to better support patients receiving MAT.
3. Putting emergency department physicians on the front lines of initiating MAT. Working with the Michigan Opioid Prescribing Engagement Network, or Michigan OPEN, we’ll be helping emergency department physicians receive training so they can screen patients for opioid use disorder, initiate MAT treatment and refer patients to MAT providers for continued treatment. Emergency department physicians are in a unique position to address the opioid crisis by providing point-of-care treatment. 

Incentives
To help encourage more practices to receive waiver training and offer medication-assisted treatment to people with substance use disorder, we’re offering incentives as follows:

1. MAT Practice Transformation Program Incentive — We’re providing up to $20,000 per practice for those who didn’t deliver MAT from Jan. 1, 2019, through Sept. 20, 2019, and begin providing the service. Practices receive $10,000 for the first patient they provide with MAT. Practices will then receive another $10,000 when they treat their 10th MAT patient. This is for PCMH-designated practices only.
2. Value-based reimbursement — Providers who deliver MAT will receive a 5% fee increase whether they were previous MAT providers or have newly implemented the service. Reimbursement depends on meeting specific thresholds and timelines. Providers should reach out to their physician organization for details.

Waiver training
It’s crucial that a significant number of health care providers throughout the state participate in this program to ensure that people in need have access to trained providers. To help accomplish this, Blue Cross is promoting waiver training sessions for primary care providers at various locations throughout the state. For more details, see the related article, Free training opportunities offered, also in this issue.

Initially, only primary care physicians are included in the MAT Practice Transformation Program, but it may be available to other specialties in the future. We’re also looking at expanding the program to our HMO, Blue Care Network.

We’ll have more details about the program in the January – February issue of Hospital and Physician Update.