• Mackenzie Farrar, Zach White, Stephen Hulkower, E Blake Fagan, and Courtenay Gilmore Wilson.
• From the Mountain Area Health Education Center (MAHEC), Asheville, NC (MF, ZW, SH); University of North Carolina (UNC) School of Medicine Chapel Hill, NC (SH, EBF, CGW); Centers for Disease Control and Prevention Foundation, Atlanta, GA (EBF); UNC Health Sciences at MAHEC Asheville, NC (EBF, CGW); UNC Eshelman School of Pharmacy, Chapel Hill, NC (CGW).
• J Am Board Fam Med. 2020 Jan 1; 33 (1): 124-128.

IntroductionOpioid use disorder (OUD) affects 2 million Americans, yet many patients do not receive treatment. Lack of team-based care is a common barrier for office-based opioid treatment (OBOT). In 2015, we started OBOT in a family medicine practice. Based on our experiences, we developed a financial model for hiring a team member to provide nonbillable OBOT services through revenue from increased patient volume.MethodsWe completed a retrospective chart review from July 2015 to December 2016 to determine the average difference in medical visits per patient per month pre-OBOT versus post-OBOT. Secondary outcomes were the percentage of visits coded as a Level 3, Level 4, and Level 5, and the percentage of patients with Medicaid, private insurance, or self pay. With this information, we extrapolated to build a financial model to hire a team member to support OBOT.ResultsTwenty-three patients received OBOT during the study period. There was a net increase of 1.93 visits per patient per month (P < .001). Fourteen patients were insured by Medicaid, 7 had private insurance, and 2 were self pay. Twenty-three percent of OBOT visits were Level 3, 69% were Level 4, and 8% were Level 5. Assuming all visits were reimbursed by Medicaid and accounting for 20% cost of business, treating 1 existing patient for 1 year would generate $1,439. Treating 1 new patient would generate $1,677.ConclusionsIn a fee-for-service model, the revenue generated from increased medical visits can offset the cost of hiring a team member to support nonbillable OBOT services.© Copyright 2020 by the American Board of Family Medicine.

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