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The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
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Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
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Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
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Designing Complex Care Management Programs to Support Patients With Substance Use Disorder: An Essential and

Kelly M Schuering1,2, Daniel P Martin1, Deborah Goldfarb1,3

  • 1Population Health Services, Boston Medical Center (Drs Schuering, Martin, Ms Goldfarb, Ms Nahrgang, Drs Galbraith, and Pace), Boston, MA.

The Journal of Ambulatory Care Management
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PubMed
Summary
This summary is machine-generated.

Care management programs can improve outcomes for individuals with substance use disorders (SUDs). Adapting staffing and training enhances patient engagement and reduces overdose rates, though further research is needed.

Keywords:
Medicaid accountable care organizationscare managementcomplex careharm reductionsubstance use disorder

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Area of Science:

  • Healthcare Management
  • Public Health
  • Addiction Medicine

Background:

  • Individuals with substance use disorders (SUDs) experience significant health comorbidities and high healthcare costs.
  • Medicaid accountable care organizations (ACOs) can benefit from improved care management for SUD patients.
  • Limited reports exist on effective strategies for integrating SUD care into existing management programs.

Purpose of the Study:

  • To describe the adaptations made by the Boston Medical Center Health System Complex Care Management (CCM) program to better serve patients with SUDs.
  • To outline strategies for enhancing care management capacity for individuals with SUDs within Medicaid ACOs.

Main Methods:

  • Adjusted staffing models, recruitment, and training focused on SUDs, harm reduction, motivational interviewing, and trauma-informed care.
  • Embedded staff in inpatient and community settings with access to behavioral health support.
  • Developed partnerships with community, governmental, and healthcare organizations for comprehensive care coordination.
  • Implemented strategies for patient identification, engagement, and addressing health-related social needs.

Main Results:

  • Most patients with SUDs agreed to CCM enrollment upon outreach, indicating potential for improved reach and sustained engagement.
  • Preliminary data show CCM-enrolled patients experienced lower overdose rates.
  • CCM-enrolled patients demonstrated higher engagement with outpatient care for SUDs, mental health, and medication for opioid use disorder.

Conclusions:

  • Care management staff, with proper training and tools, can significantly improve outcomes for individuals with SUDs.
  • The CCM program's adaptations demonstrate a viable model for supporting this high-need population.
  • Further research is necessary to evaluate the specific impact of intervention components on patient outcomes.