Ensuring your network is adequate to meet the needs of members with opioid use disorder is key to your opioid safety initiative. First, estimate the number and location of your members who may be at risk for opioid dependence. Second, estimate the number of waiver-trained providers needed to provide appropriate levels of access to medication-assisted treatment (MAT) for these members. We provide a workforce calculator that will help you project the number of waiver-trained physicians you will need to meet the needs of your at-risk members.
How to Do It
- Identify at-risk members / opioid hot spots; at-risk members include members who:
- Are on risky regimens
- Have emergency department (ED) events associated with opioids/overdoses
- Are experiencing prescriber changes
- Require enhanced case management
- Require referrals to addiction treatment
- Understand access to appropriate levels of care across the network, and ensure MAT is available throughout the system (ED, primary care, and hospitals).
- Identify gaps in at-risk member access to critical providers, including lack of critical providers and long wait times for referrals and appointments.
Health Plan Stories
Central California Alliance for Health
Workforce Projection Calculator
Download the Waiver-Trained Workforce Projection Calculator (ZIP), also available below. Use it to calculate how many physicians who are waivered to prescribe buprenorphine would be needed in your network to meet demand.
Sample Topics for Waiver Prescriber Mentor Meetings
Several health plans have created formal mentoring programs in which they pair newly trained providers with experienced providers who are able to answer questions and offer advice and coaching. Some health plans have also established mentor groups that meet regularly and discuss a range of topics related to opioid safety and pain management.
The list below includes suggested topics and related subtopics for such mentor meetings. This list is not exhaustive and should be tailored to the specific challenges the mentee is facing.
Download this tool: Sample Topics for Waiver Prescriber Mentor Meetings (PDF).
- American Society of Addiction Medicine Levels of Care and Continuum: Use these criteria to assess patients and recommend a suite of services.
- Pre-Manage/EDIE: These tools support interventions with high-risk members, and data sharing with hospitals and emergency departments.
- California County Fact Sheets: These fact sheets from the Urban Institute describe the need for opioid treatment services in every California county.