CleanSlate Addiction Treatment Centers, a provider of outpatient medication-assisted therapy (MAT) with 10 locations in Massachusetts, is capitalizing on the unmet need for opioid-abuse treatment among Medicaid populations. The organization this year expanded into Pennsylvania with one center open currently and another scheduled to open in October.
Amanda Wilson, MD, president and CEO, anticipates operating a total of eight locations across Pennsylvania with growth plans to add additional states to the portfolio. A portion of CleanSlate is backed by private equity investors Apple Tree partners, and funding has been invested in compliance structure and a call center, as well as intake, legal and human resource teams—all of which came together in the last year.
“There are many patients out there who need this care, and we felt it was ethically questionable that there was nobody providing it well to patients with Medicaid insurance,” Wilson says. “We decided to open centers, make use of nurse practitioners and build a cost-efficient model that can also provide high-quality care to everybody, regardless of their insurance.”
When CleanSlate was founded six years ago, 500 patients sought treatment in the first three-and-a-half months, and weekends at the centers were flooded because of the high demand for MAT in Massachusetts. Wilson says other states are demonstrating similar demand.
The CleanSlate model
Wilson, an internal medicine physician who pursued a board certification in addiction medicine, says what started CleanSlate was her realization of the imbalance between the volumes of prescribed opioids versus medication-assisted therapies like buprenorphine, as well as the limitations on prescribing those therapies.
“There are about 28,000 doctors who are waivered of the 900,000 in this country, and only about 6,000 of them have moved up to the 100-patient limit,” Wilson says.
Physicians usually treat an average of seven to 14 buprenorphine patients because such patients are often highly complex and need frequent office visits. To offset this, CleanSlate’s model relies on physicians who aren’t necessarily willing to manage 100 patients in their own offices but would see them in a separate setting optimized for MAT.
“On site, we have four to six nurse practitioners; an addiction board certified physician, who supervises the nurse practitioners and sees patients regularly; and part-time doctors who come in and work weekly for a couple of hours,” Wilson says. “The doctors are willing to have 100 patients because they know they’re going to be managed tightly by this team approach, which provides ongoing individualized care.”
Commercial payers and states are contacting CleanSlate. Wilson has been in recent communication with Indiana’s Health and Human Services department to address regions that have limited access to medication-assisted therapy. Multiple behavioral health group partnerships are in the works throughout the state as well.
Most recently, CleanSlate joined the network for Geisinger Health Plan in Danville, Pa., which has 500,000 enrollees.
There also are discussions to expand to Oregon, Ohio and Kentucky, which would take place in the third or fourth quarter of 2016 or quarter one of 2017, Wilson says.