Hudson River HealthCare, Inc.

In 2017, New York had nearly 4,000 drug overdose deaths, of which more than 3,200 involved opioids.

The State’s rural communities, including Sullivan County, are at the epicenter of this crisis. From 2015–2017, Sullivan County had the highest drug poison death rate in the State. One strategy to reduce opioid-related abuse includes Medication Assisted Treatment (MAT) programs. These programs typically include pharmacotherapy with low-dose opioids that are used to treat opioid addiction; provider and community education on opioid use disorder; and coordination with related specialty medical and social service providers. In 2019, NYHealth awarded a grant to Hudson River HealthCare (HRHCare) to pilot an RN-led MAT model and compare it with existing physician-led MAT models.

Under this grant, HRHCare established an RN-led MAT model at its site in Sullivan County and evaluated whether this lower-cost model achieves clinical, financial, and process outcomes that are comparable to the traditional physician-led model currently used throughout New York State. HRHCare based its pilot on a successful Massachusetts model that placed an RN care manager in charge of screening, evaluating, and educating patients, and then consulting with a physician to confirm diagnosis and initiate the treatment plan. HRHCare contracted with an independent health care research organization to evaluate the pilot program and compared it with the traditional physician-led model. From the evaluation, HRHCare developed an issue brief outlining the key findings and incorporating operational feedback, training considerations, and policy avenues to support future implementation efforts for the RN-led MAT program. If the pilot proves to be successful, there could be a variety of policy implications for New York State, such as making the model a Medicaid-reimbursable service; an expansion of training for RN care managers to serve in this primary role; and a contribution to the ongoing national conversation about designating RNs as waived MAT providers.