SCF’s Relationship-Based Approach to Substance Use Disorders

Opioid addiction has become a major public health crisis in many parts of the United States, and people are increasingly looking to health care organizations for answers. Southcentral Foundation has implemented a comprehensive approach to handling opioids and opioid addiction based on SCF’s system of relationship-based care and integrated behavioral health. This relationship-based approach to substance use disorders includes prescription guidelines for providers, care plans for working with patients, and medication-assisted treatment integrated into primary care.

Wellness Care Plans

As discussed previously on this blog, SCF has integrated behavioral health providers into our primary care clinics. Behavioral health consultants have multiple roles in dealing with opioid prescription and treatment, including working with primary care providers and customer-owners in establishing Wellness Care Plans, which are required when maintenance opioids for chronic pain are being prescribed, and assessing and working with customer-owners who may need treatment for a substance use disorder.

Prescription Guidelines

SCF has also established guidelines for the prescription of opioids; these guidelines cover a wide variety of topics, including how to assess whether a particular medical condition would benefit from opioid prescription, effective methods for follow-up care, and how and when to taper off opioids. These guidelines help establish a set of system-wide standards so that messaging to customer-owners is clear and consistent. The standards also help with the creation of educational materials for customer-owners. SCF monitors aggregate data regarding the prescription of opioids; this data shows that from November 2015 to November 2017, SCF has managed to reduce the prescription of opioids by approximately 45 percent.

Medication-Assisted Treatment

Medication-assisted treatment for customer-owners dealing with substance use disorders is another important component of SCF’s overall approach to opioids. Primary care providers, behavioral health consultants, and SCF’s Four Directions Outpatient Treatment Center can all play a role in this treatment, and customer-owners can fluidly move between services depending on their needs. Once treatment has been undertaken, the customer-owner checks in with their integrated care team within 1-6 months to determine the effectiveness of treatment and to address any additional needs that may arise. Through provider training and support, SCF has managed to increase the number of primary care providers approved for medication-assisted treatment from approximately 10 percent to approximately 70 percent, making this treatment more available to customer-owners who might need it.

We are still working to change and improve the system for customer-owners based on their feedback and our analysis, but SCF’s experience shows that a relationship-based approach to substance use disorders can prove an effective way to handle opioid prescription and treatment.