Effectiveness of Washington State’s Hub & Spoke Model to Improve Opioid Use Disorder Outcomes
Sharon Reif, Maureen T Stewart, Shay M Daily, Lee Panas, Grant Ritter, Mary F Brolin, Margaret T Lee, Jennifer J WicksAbstract
Introduction
Innovative strategies remain necessary to increase utilization of medications for opioid use disorder (MOUD), an effective approach to reduce overdoses and deaths. The Hub and Spoke (HS) model is increasingly used to improve MOUD treatment, yet the impact is relatively unknown. We assessed the effectiveness of Washington State’s model (WA-HS) on six-month outcomes of MOUD continuity and health care utilization.
Methods
We analyzed 25,368 adult Medicaid beneficiaries with new MOUD episodes in 2016-2019, comparing HS and non-HS cohorts in the six months after starting MOUD.
Results
Across both cohorts, 26% stayed on MOUD for six months, and within six months of MOUD initiation, 42% had an ED visit, 14% any hospitalization, and 13% entered intensive substance use treatment. No significant differences were found between cohorts for all outcomes.
Conclusions
Our null findings likely reflect the complexity of the OUD crisis, the many needs of people with OUD that require flexible approaches at the individual and systems levels, and the WA-HS focus on MOUD initiation. Findings highlight the need to ensure HS models incorporate strategies to address MOUD continuity to drive long-term recovery for people with OUD.