Development of a Low-Barrier, Reimbursable Take-Home Naloxone Program at a Regional Health System

Area of Science:

• Public Health
• Emergency Medicine
• Pharmacology

Background:

• Emergency departments (EDs) can reduce opioid overdose deaths by dispensing take-home naloxone (THN) to at-risk patients.
• Sustainable reimbursement and workflow integration models for ED-based THN programs are limited.

Purpose of the Study:

• To evaluate a reimbursable, ED-led THN program implemented across a large regional health system.
• To assess the feasibility and outcomes of integrating THN into routine ED workflows.

Main Methods:

• Developed an ED-led THN program with electronic health record (EHR)-integrated ordering and on-site dispensing.
• Utilized third-party insurance billing and supplemented with public supply for uninsured patients.
• Tracked dispensed kits and reimbursement rates across eight EDs.

Main Results:

• 2,520 naloxone kits dispensed across eight EDs (2019-2024).
• Insurance reimbursement increased from 46% (2019) to 95% (2025); 89.9% of kits were covered by insurance or public supply.
• Kit distribution grew significantly, indicating program expansion and improved engagement.

Conclusions:

• A reimbursable ED-led naloxone program effectively increases access to overdose-reversing medication.
• Integrating THN into EHRs, utilizing insurance billing, and public health partnerships creates a sustainable, low-barrier model for other health systems.