{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:27:46Z","timestamp":1790288866274,"version":"4.1.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Population Health Management"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>\n                    Opioid use disorder (OUD) is a national crisis. Health care must achieve greater success than it has to date in helping opioid users achieve recovery. Integration of comprehensive primary care with treatment for OUD has the potential to increase care access among the substance-using population, improve outcomes, and reduce costs. However, little is known about the effectiveness of such care models. The Comprehensive Care Practice (CCP), a primary care practice located in Maryland, implemented a care model that blends buprenorphine treatment for OUD with attention to primary care needs. This study evaluates the model by comparing patients with OUD treated in CCP and other Maryland facilities in a large state Medicaid program. Compared to the non-CCP patient group (n\u2009=\u2009867), the CCP group (n\u2009=\u2009131) had a higher 6-month buprenorphine treatment retention rate (79% vs. 61%, adjusted average marginal effect (AME)\u2009=\u20090.17,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.001). CCP patients also had fewer hospital stays in the 12-month follow-up period (0.22 vs. 0.41, AME\u2009=\u2009-0.17,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.005), and lower total cost (US$10,942 vs. $13,097, AME\u2009=\u2009-$4554,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.001) and hospital stay cost (US$1448 vs. $4265, AME\u2009=\u2009-$2609,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.001), but higher buprenorphine pharmacy cost (US$3867 vs. $2781, AME\u2009=\u2009$987,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.001). Other measures, including emergency department utilization and cost, substance abuse cost, and non-buprenorphine pharmacy cost, were not statistically different between the 2 groups. Results suggested that patients, as well as the health care system, can benefit from an integrated model of buprenorphine treatment and primary care for OUD with better treatment retention, fewer hospital stays, and lower costs.\n                  <\/jats:p>","DOI":"10.1089\/pop.2018.0163","type":"journal-article","created":{"date-parts":[[2018,12,13]],"date-time":"2018-12-13T15:25:04Z","timestamp":1544714704000},"page":"292-299","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["Integration of Buprenorphine Treatment with Primary Care: Comparative Effectiveness on Retention, Utilization, and Cost"],"prefix":"10.1177","volume":"22","author":[{"given":"Yea-Jen","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill A.","family":"Marsteller","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah G.","family":"Kachur","sequence":"additional","affiliation":[{"name":"Johns Hopkins HealthCare, Glen Burnie, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael I.","family":"Fingerhood","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland."},{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,8,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2017.16265"},{"key":"e_1_3_2_3_2","unstructured":"Centers for Disease Control and Prevention (CDC). Annual Surveillance Report of Drug-Related Risks and Outcomes\u2014United States 2017. https:\/\/www.cdc.gov\/drugoverdose\/pdf\/pubs\/2017-cdc-drug-surveillance-report.pdf Accessed October19 2018"},{"key":"e_1_3_2_4_2","first-page":"902","article-title":"Characteristics of high-cost patients diagnosed with opioid abuse","volume":"21","author":"Shei A","year":"2015","unstructured":"Shei A, , Rice JB, , Kirson NY, et al. Characteristics of high-cost patients diagnosed with opioid abuse. 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Trends in the use of methadone buprenorphine and extended-release naltrexone at substance abuse treatment facilities: 2003\u20132015 (Update). Rockville MD: Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration 2017."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.12.024"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.7326\/M15-0510"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.3109\/15360288.2010.501851"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2005.11.6.469"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.3109\/15360280903544877"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303558"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000703"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/add.13364"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1735"},{"key":"e_1_3_2_30_2","unstructured":"Olsen Y Bass E McCaul ME Steinwachs D. 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