Vanderbilt University Medical Center, Vanderbilt University School of Medicine, Nashville, Tennessee (Marcovitz, Pettapiece-Phillips, Kast, White, Audet); Department of Surgery and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago (Himelhoch). Debra A. Pinals, M.D., Enrico G. Castillo, M.D., M.S.H.P.M., and Ayorkor Gaba, Psy.D., are editors of this column.
Psychiatr Serv. 2022 Jul;73(7):819-822. doi: 10.1176/appi.ps.202100343. Epub 2021 Dec 8.
Hub-and-spoke (H&S) partnerships for managing opioid use disorder vary by U.S. state. This column provides the first description of the development of an H&S partnership in Tennessee, a Medicaid nonexpansion state. Medicaid expansion allows states to fund evidence-based substance use disorder treatment and community-based psychosocial interventions. In an H&S model in a Medicaid nonexpansion context, federal grant support must fund not only treatment itself but also the creation and maintenance of parallel billing and documentation processes for various partners, reducing the funds available for patient care.
美国各州管理阿片类药物使用障碍的枢纽辐射型（H&S）合作关系各有不同。本专栏首次介绍了田纳西州 H&S 合作关系的发展情况，该州未扩大医疗补助计划（Medicaid expansion）。医疗补助计划扩大了各州为循证药物使用障碍治疗和社区心理社会干预提供资金的能力。在 Medicaid 未扩大的背景下的 H&S 模式中，联邦赠款支持不仅必须用于治疗本身，还必须用于为各个合作伙伴创建和维护平行计费和文件处理流程，这减少了可用于患者护理的资金。
