Treatment options grow to battle rising opiate crisis
Vic DiGravio of the Association for Behavioral Healthcare: Demand for treatment “far outstrips” capacity.
From July 2013 through June 2014, nearly 5,000 people sought treatment for substance abuse in Worcester. For 62 percent of them, the drug in question was heroin.
Growth in opiate abuse in recent years is well documented in Central Massachusetts and across New England. In an effort to combat it, the state last year passed legislation to make it easier for those affected to seek treatment. Among other things, beginning in October, the law will require private insurers to cover residential treatment programs when patients need them.
Between the growing need for services and the improved ability to get paid for providing them, new players are entering the Massachusetts substance abuse treatment market. Out-of-state companies are planning new facilities in the eastern part of the state. Meanwhile, in Central Massachusetts, Worcester-based Spectrum Health Systems Inc. and Gardner’s Heywood Hospital both intend to open new inpatient treatment centers.
“We are seeing an uptick in entities looking to open new treatment beds in Massachusetts,” said Vic DiGravio, president and CEO of the Natick-based Association for Behavioral Healthcare. “There’s incredible demand for treatment. The demand … far outstrips the capacity to provide treatment at this point in time.”
DiGravio said that right now, MassHealth, the state’s Medicaid program for low-income residents, typically provides the best coverage for inpatient treatment. Under the new law, private insurers must also cover several days of intensive detox — essentially the medical process of cleaning drugs from the patient’s body — as well as step-down programs that continue medical treatment while beginning to address the underlying addiction.
From treatment to recovery
After patients graduate from those intensive treatment levels, DiGravio said, they may move on to transitional support and residential recovery homes.
Those programs typically aren’t covered by Mass Health or other insurers. Instead, they’re funded through state contracts and open to everyone, regardless of their insurance. Meanwhile, DiGravio said, there are also facilities where families pay cash, but those are less common in Massachusetts.
The new centers being planned across the state include two new locations in Wenham and Danvers for the for-profit Recovery Centers of America. Another for-profit company, Acadia Healthcare, is building a new hospital for treatment of mental illness and substance abuse in Dartmouth in partnership with Southcoast Health.
In Central Massachusetts, Spectrum is replacing an existing residential facility in Westborough, increasing its capacity from 80 to 100 beds. Meanwhile, it’s adding a 36-bed private-pay facility called the New England Recovery Center. Spokesman Brendan Melican said Spectrum has always focused on publicly funded care, but it’s starting to broaden its offerings.
“The whole industry is seeing demand from people for smaller facilities catering just to people who pay out of pocket,” he said.
In-state expansion for Spectrum Health
Spectrum CEO Charles Faris has said the private-pay facility will help pay for the parallel, publicly funded site. Meanwhile, the company continues to launch new outpatient services. In early May, it opened a medication-assisted treatment program in North Adams and a support center focused on peer-based groups in Lawrence.
In the northern part of Central Massachusetts, meanwhile, Heywood Hospital is moving through the regulatory process for Quabbin Retreat, a behavioral health and substance abuse treatment center in Petersham. The hospital expects the center to open early next spring and eventually grow to include 65 beds for substance abuse and detox treatment, plus another 20 for mental health treatment.
Rebecca Bialecki, Heywood’s vice president for community health initiatives, said the center will accept all payers. While the plan for the facility was in place before the state’s new insurance rule was approved, Bialecki said it helps that more private insurance money will be available for this sort of treatment by the time it opens.
According to Heywood, Central Massachusetts, and North Central in particular, is underserved to the point where Heywood turns away 2,500 patients in urgent need of care every year.
“In our region, we’ve been particularly hard hit by the opiate crisis, which is driving a lot of the increase in demand,” Bialecki said. “North Worcester County has literally no services at all at this point, aside from some outpatient treatment.”
Even before the new location opens, Heywood is working to address the crisis, said Dawn Casavant, vice president of external affairs and chief philanthropy officer. With the help of state funding, the hospital has been building systems over the past two years to provide continuing care for addicts who frequently end up at the hospital’s emergency departments in Gardner and Athol. The program’s employees check in with the patients regularly and help them find services such as transportation and child care so they can get regular care in a less intensive setting.
New insurance rules will help patients
At AdCare, the Worcester hospital that serves substance abuse patients, Lisa Clark, vice president of marketing and business development, said the new insurance rules should be a big help for patients. Right now, she said, getting insurance approval can be a “lengthy, onerous process,” particularly since each insurer has its own set of policies.
Clark said AdCare has been hit hard by the area’s increased opiate problem. “We are pretty much running a waiting list constantly,” she said.
Clark said one benefit from the expanded insurance coverage should be that patients can get whatever kind of help that’s most appropriate for their condition. Right now, she said, it’s common for addiction to go unaddressed for too long, or be addressed with inappropriate treatment.
“The goal is really to admit the patient to the level of care that they need,” she said. “You wouldn’t treat somebody that was having a heart attack the same way you’d treat somebody with high cholesterol.”
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