Ophelia, a physician practice that treats opioid addiction, today announced it has been designated as an Opioid Use Disorder (OUD) Center of Excellence (COE) by Pennsylvania’s Department of Human Services, becoming the first virtual-first and statewide COE. Ophelia uses a virtual-first care model to improve access and retention in evidence-based OUD treatment by lowering barriers to care for rural, underserved, and historically stigmatized patient populations. Since entering Pennsylvania in 2020, it has served thousands of Medicaid beneficiaries in the state.
The opioid epidemic is Pennsylvania’s number one public health and safety challenge, with an average of 14 Pennsylvanians dying from overdose every day – twice the national average. The pandemic and the prevalence of synthetic opioids, including fentanyl, are two primary drivers of increased overdose deaths in the last several years. Pennsylvania’s COE program was created in 2016 as a response to the opioid epidemic to ease barriers to comprehensive treatment for patients with OUD and increase access to medication-assisted treatment (MAT), which can reduce overdoses by 76%.
Pennsylvania’s COE program has rigorous standards that each provider must meet to ensure that patients receive comprehensive, evidence-based treatment. Ophelia’s COE designation allows another model of care for people who may, for various reasons, be unable or reticent to use in-person care. Greater use of telehealth has been made possible by regulatory reform in recent years. This step is consistent with federal guidance from the CDC, NIH, and CMS, which concluded from real-world data that telehealth treatment for OUD is effective and lifesaving. Ophelia has secured referral agreements with traditional, brick-and-mortar care providers and will provide warm handoffs to in-person treatment options should patients need more intensive support.
“The Centers of Excellence were designed as a patient-centered model of care that sought to make treatment and recovery an accessible, approachable, and sustainable part of a person’s life,” said Human Services Secretary Dr. Val Arkoosh. “A virtual-first approach to this treatment gives us more opportunities to meet people where they are and get them the life-saving care they deserve. We are encouraged that a medical practice can see the value of this model and are using it to pursue further innovation, and we look forward to assessing the impact Ophelia’s approach to our Centers of Excellence Model can have on Pennsylvanians affected by the disease of addiction.”
Pennsylvania’s Medicaid managed care organizations (MCOs) are dedicated to delivering high-quality, accessible care and are expected to offer patients a robust network of COE providers. Physical HealthChoices MCOs that include Ophelia in their network reach beneficiaries statewide. A recent Health Affairs Scholar study found that when patients, including Medicaid beneficiaries, are able to see an in-network physician practice like Ophelia, they are 50% more likely to remain in care for six months, demonstrating the critical link between the affordability of care, improved treatment outcomes, and cost savings to payors.
“Telehealth-based OUD treatment saves lives and lowers costs for payors, but it’s only possible if reimbursement is available to keep providers whole,” said Zack Gray, CEO and founder of Ophelia. “Meanwhile, Medicaid covers nearly half of all patients with OUD, but most states have not yet evolved their fee schedules to reimburse it sufficiently. Pennsylvania has set an example for the rest of the country about what is possible and needed in Medicaid, and we hope that other states will take notice and follow suit.”
Ophelia patients can connect with a clinician from the privacy of their home and schedule virtual appointments that fit around their schedule, including evenings and weekends. Clinicians and care coordinators are available on demand, seven days per week, to assist with treatment challenges, pharmacy and insurance issues or to refer to and collaborate with external providers. All Ophelia clinicians are trained in addiction medicine, employed by the company, and licensed in the patient’s state.
For more information, visit ophelia.com, and to read testimonials from Ophelia patients, visit the company’s Google Reviews.
About Ophelia
Ophelia is a digital provider of medication-assisted treatment (MAT) for opioid use disorder (OUD), committed to making evidence-based treatment universally accessible. Its mission is to remove barriers for the 80% of Americans with OUD who are unable to access care. At its core is the Ophelia Care Model, a team-based clinical model and software platform developed by leading experts in addiction medicine and psychiatry. Ophelia is licensed to provide care in 30+ states and accepts Medicaid, Medicare, and Commercial insurance.
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