Helping primary care stop substance use disorder before it starts

Crises such as the nation’s current opioid epidemic call for clinical innovation combined with experience that has proven to be effective. At Beacon Health Options, we tapped into both to create the Massachusetts Consultation Service for Treatment of Addiction and Pain (MCSTAP) to help primary care providers (PCPs) treat patients with chronic pain and/or substance use disorder (SUD).

PCPs made it clear in a 2018 needs assessment that they need real-time support in addition to the many educational resources already available. Based on the successful MCPAP – the Massachusetts Child Psychiatry Access Program – MCSTAP’s mission is to support PCPs in using evidence-based practices to screen, diagnose, treat and manage these patients. To do so, MCSTAP provides real-time, telephonic consultation on safe prescribing and generally managing patients’ care. This January marks the program’s first anniversary.

How it works

Funded by the Executive Office of Health and Human Services and administered by Beacon’s Massachusetts Behavioral Health Partnership, MCSTAP is available Monday through Friday, 9 a.m. to 5 p.m. to all Massachusetts PCPs.  The program does not charge and supports all providers within a primary care practice, including physicians, nurse practitioners, physician assistants, registered nurses, behavioral health clinicians and care managers, who treat patients with chronic pain and SUD, regardless of insurance coverage.

As with the now well-established MCPAP, PCPs can get real-time consultation from a physician consultant who, based on information about the patient, provides diagnostic support; guidance on medication prescribing; treatment planning; and any community support needs. The provider can expect a call back within 30 minutes or at a time the provider specifies.

Simple yet effective solution

To help people live complete and healthy lives, Beacon pursues clinical innovation to solve the most urgent and complex mental health challenges, while also working towards ensuring access to high-quality, integrated care. Endorsed by the Massachusetts Medical Society, MCSTAP is yet another example of how healthcare organizations can apply the tools already known to us to drive innovative solutions. In the case of MCSTAP, telehealth and specialty expertise combine to fill gaps in care that historically have been so difficult to fill.

“MCSTAP’s mother program – MCPAP – has been very successful and replicated in more than 30 states,” said John Straus, MD, medical director special projects at Beacon and MCPAP founding director and innovator. “Why wouldn’t we apply the same model for SUD, a condition that continues to plague the country, with little access to services? We know the model works, and it only makes sense to apply it where it’s needed.”

To help people live complete and healthy lives, Beacon pursues clinical innovation to solve the most urgent and complex mental health challenges, while also working towards ensuring access to high-quality, integrated care.

Feedback from providers has been more than positive, and so far, more than a third of all callers have called MCSTAP for multiple cases. One provider states: “I was very happy with my MCSTAP consult. This was my third time using the service, and the prompt turnaround in guidance provided is invaluable. It is such a relief to be able to get care plans optimized for patients so rapidly so any changes made can be validated by a specialist in the field. It’s priceless. I would rate it a 5”.

Another provider adds: “The information was extremely helpful and gave me much more confidence, and a feeling of safety, in dealing with a complicated patient. . . .The physician consultant was great. She sent me some good educational resources and talked me through information-gathering and decision-making. She also reached out to follow up with me more than once”.

While no single innovation will address the needs of any given group, such as people with chronic pain and SUD, programs like MCSTAP illustrate how critical innovation is to addressing relentless healthcare challenges.

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