Buprenorphine can be provided in a sustainable way, researchers find

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Primary care practices in high-poverty rural and urban communities struggling financially can offer opioid addiction treatment medication that is buprenorphine-based in a financially sustainable way, although many are unsure how to do so, a team of Harvard Medical School researchers found.

The researchers conducted cost and revenue analysis then used modeling to identify the cost and financial benefit of delivering buprenorphine-based treatment in four primary care settings. The settings were practices outside of high poverty areas, Federally Qualified Health Centers (FQHC), and non-FQHCs in rural and urban high poverty areas.

In all four settings, there was positive net revenue after the first year. In rural practices, net revenues were the highest.

The practices with the largest net revenue gains were shared medical visits and physician-led treatment. These practices generated from $29,000 to $70,000 per full-time physician annually.

Practices with at least nine patients in buprenorphine treatment had higher net revenues with no-show rates of less than 34 percent.

The researchers interviewed practice managers and discovered the approaches for delivering buprenorphine-based treatment differed based on whether care was in one-on-one or group settings, nurse care managers were present, and the person delivering most of the face-to-face care.

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