2017
DOI: 10.1097/adm.0000000000000310
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Vermont Hub-and-Spoke Model of Care for Opioid Use Disorder: Development, Implementation, and Impact

Abstract: Background Opioid use disorders (OUDs) are reaching epidemic proportions in the United States, and many geographic areas struggle with a persistent shortage in availability of opioid agonist treatment. Over the past 5 years, Vermont addiction medicine physicians and public health leaders have responded to these challenges by developing an integrated hub-and-spoke opioid treatment network. Methods In the present report, we review the development, implementation, and impact of this novel hub-and-spoke model fo… Show more

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Cited by 174 publications
(153 citation statements)
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“…The 21st Century Cures Act included a two-year $1 billion investment in enhancing treatment access. Programs that train physicians in how to prescribe buprenorphine or link private physicians to opioid treatment programs, such as the “hub-and-spoke” model, have demonstrated effectiveness in increasing access to buprenorphine (14). Also, more private payers are removing prior authorizations and other formulary restrictions on treatments for opioid use disorder (15).…”
Section: Discussionmentioning
confidence: 99%
“…The 21st Century Cures Act included a two-year $1 billion investment in enhancing treatment access. Programs that train physicians in how to prescribe buprenorphine or link private physicians to opioid treatment programs, such as the “hub-and-spoke” model, have demonstrated effectiveness in increasing access to buprenorphine (14). Also, more private payers are removing prior authorizations and other formulary restrictions on treatments for opioid use disorder (15).…”
Section: Discussionmentioning
confidence: 99%
“…Although using a logic model–as had been done in earlier research–provided a beneficial structure on which to build, the evaluation would have more utility for the field if it had measures developed in earlier research. The state of Vermont's hub‐and‐spoke program (Brooklynn & Sigmon, ) has developed some of its own measures, including a Treatment Needs Questionnaire, and further psychometric development of these measures can be a boon to the field. Although drug screens were performed for clinical purposes, the results of the screens were not part of the research reported here.…”
Section: Discussionmentioning
confidence: 99%
“…In a more recent development, the state of Vermont has been piloting a “hub‐and‐spoke” model for providing medication‐assisted treatment of opioid use disorder (OUD; Brooklyn & Sigmon, ; Mohlman, Tanzman, Finison, Pinette, & Jones, ; Saunders & McGovern, ; Simpatico, ). In Vermont, regional designated specialty addictions treatment centers (the hubs) provide specialty health, home, and medication‐assisted treatment services, while teams of health care professionals (the spokes) prescribe medication‐assisted drug treatment.…”
Section: Introductionmentioning
confidence: 99%
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“…In response to the inadequate treatment access despite successfully increasing the number of potential buprenorphine providers, Vermont developed and implemented a model of care called the “Hub and Spoke” [80], a model used previously for the treatment of chronic and often complex diseases. A “hub” is a specialized expert center (in this case, there were 5 regional hubs identified to provide statewide coverage) that are able to assist regional providers (the “spokes”) by providing expert care advice and also allowing for seamless transfer of patients from community providers back and forth between the hub and ppoke as needed (e.g., for restabilization, induction or re-induction, complex associated medical issues).…”
Section: Models Of Care For Medication Treatmentsmentioning
confidence: 99%