A Resource for Healthcare and Social Services Professionals
The Massachusetts Model
In 2003, Boston Medical Center's Office Based Addiction Treatment (OBAT) Program was created to address a key barrier to the integration of buprenorphine treatment identified by many office-based settings: lack of structured clinical support for physician providers. Nationally recognized and nationally replicated, the BMC OBAT Program has been treating patients for over 14 years using a collaborative care model that relies on nurse care managers to ensure delivery of high quality addiction treatment while effectively and efficiently utilizing the time of physicians waivered to prescribe buprenorphine.
Dubbed the "Massachusetts Model," BMC's OBAT Program serves as a model of service delivery for facilitating access to life-saving treatment and improving treatment outcomes in patients with opioid use disorders, and has been expanded to include treatments for other substance use disorders as well. BMC's OBAT Program is integrated into the organization's primary care and specialty outpatient clinics.
Under the BMC OBAT (or Massachusetts) Model nurses take a lead role in patient care. Each nurse care manager partners with a physician who assesses the patient and prescribes medication for addiction treatment (MAT). The patient's other health care needs are addressed at the same time as their substance use disorder, similar to the way that other chronic medical conditions are managed. Nurses' expertise in chronic disease management and patient education makes them ideally suited to deliver ongoing care for substance use disorders. At the same time, nurse care management enables a physician, nurse practitioner, or physician's assistant to safely prescribe medications for addiction treatment (MAT) to a greater number of patients, increasing overall access to these lifesaving medications.
BMC's OBAT Program in Adult Primary Care, our flagship clinic, currently serves over 680 patients and is the largest office-based opioid treatment program of its kind in New England. The BMC OBAT Nurse Care Manager Model is effective at increasing access to evidence based treatment for addiction as well as improving the quality of care provided to patients with substance use disorders. Expansion and replication of innovative, evidence-based models, such as the Massachusetts Model, are key to increasing access to addiction treatment across the United States.
BMC OBAT success story Derrek Anderson speaks about how the program helped him end 30 years of heroin use: