Original article on Open Minds
One of the emerging trends in health and human services is the use of more consumer centric integrated care. What “integrated” exactly means is up to much debate in the field (see What’s In A Name?), but integrated care in some form or another is arising as the “go to” model of choice—and addiction services is no different.
For more, this month we talked to Steve Priest, the president and chief executive officer of Spero Health. Spero Health is a leading provider of care for people struggling with substance use disorders, including opioid addiction. Spero Health has 20 locations in Kentucky, Ohio, and Indiana, and provided care for over 5,250 patients in August 2018. Headquartered in Brentwood, Tennessee, Spero Health is privately held by Heritage Group, Health Velocity Capital, Frist Cressey Ventures, and South Central, Inc.
Their integrated approach uniquely combines both physical and behavioral healthcare services under one roof to treat the whole patient. This model combines physician office visits, behavioral health counseling, case management, recovery support services (including case management), and patient and family education. Spero Health’s integrated care model is focused on three primary approaches:
- Physician services—Use of evidenced based practices for the treatment of opioid use disorders that include mental and physical health screenings, individualized recovery plans, and medication management.
- Behavioral health counseling— Mandatory individual and/or group counseling, activities focused on treatment plan adherence, anti-diversion and developing a recovery orientated lifestyle. Sessions provide safe places to talk and valuable support to help patients achieve lasting recovery.
- Recovery support services & education—Connections back to the community and skill building assessed on individual patient needs. This can include assistance in finding employment, housing, healthcare, child care, transportation and more.
Mr. Priest explained the model as an effort to bring all services under one roof with consumer engagement and involvement in recovery as a primary strategic mission. He explained:
Our goal is to be an integrated health care provider, solely focused on patients with opioid use disorder. We believe that the most effective way to achieve long term recovery is in treating the whole person, which includes services targeting both the physical and behavioral component of this disease state. We have intentionally brought all services under one roof as it enhances a patient’s engagement and involvement in recovery. We think it’s vital to deliver outpatient care to treat patients close to home in their own environments, so they can cope with life as they start their recovery journey. Our highly trained treatment teams perform thorough assessments on all patients which determines unique needs. From there, individualized treatment plans are designed and developed to incorporate three key components; physician services, recovery support services/education and counseling. All components target different areas in recovery. For patients needing medical care, we provide the physician. Counseling both individual and group are essential to helping people learn coping skills and share with others who have shared similar challenges. We also identify areas in which our patients need support outside of our building and we work hard to connect them with things like housing, child care, transportation and job resources just to name a few.
We want all patients to get off to the right start in recovery, and at times find that some people may require more services more frequently in the beginning while they are starting to regain some stability and control in their life. Our program offers the flexibility to add additional supports based on specific needs. One of the other key components of recovery is in having a true partnership with our patients. One where we engage them to set new goals and determine what success looks like on their terms. It also includes holding them accountable through medication counts, prescription monitoring and urine drug screens.
In combination with recovery support services, education and counseling, medication can help make the recovery process easier to manage. Our treatment team collaborates to determine which type of medication is appropriate based on individual needs. Two commonly used are: Buprenorphine, also known as Suboxone and Vivitrol.
In our clinics, we intentionally put all these services under one roof, which makes us unique. Frequently, other providers will provide some of these services such as physician services but refer out the behavioral health services or vice versa. What we found is that by doing them all under one roof, we have a significantly higher involvement rate by the patients. In addition, our payor partners like our model because they know our patients are getting the care they need instead of being scattered across a variety of health care providers.
Spero is in-network with the state Medicaid plans and most major commercial insurance plans. Mr. Priest noted, “Our goal is to eliminate barriers to treatment and we value strong partnerships with insurance companies to help accomplish a shared goal of providing quality and comprehensive services to those in need.”
Spero looks at measures in a variety of phases in the consumer path to and through treatment, including:
- Assessment Phase—Measures include substance use disorder diagnosis documented; screened for trauma; screened for tobacco use, screened for HIV; hepatitis; behavioral health assessment baseline established; primary care; and physician connection established.
- Stabilization & Maintenance Phases—Measures include medication adherence/tapering documented; illicit drug use monitored; behavioral health assessment vs. baseline at 6 & 12 months; monitoring of caffeine use; sleep hygiene; and nutrition.
- Patient Well-Being Measures—These measures include improved emotional wellbeing; stress identification and management; stable living situation monitored; increased involvement in meaningful daily activities; and development of community support system.
- Brief Addition Monitor (BAM) Tool—Spero is piloting this now with rollout in Q3 planned.
- Reduction in Total Cost of Care—Currently in discussion with payors, these measures include reduction in emergency room visits; no readmission (inpatient); and total cost of care (patient & family).
Mr. Priest explained:
We are proud of the impact we have on our patients’ lives and make it a priority to get their feedback regularly. 93% of our patients feel their overall health has improved, 93% are satisfied with our treatment program and 86% report performance improvement in work or school. In addition, we have an overall treatment show rate of 88%. The window in which someone is motivated to get help can sometimes be quite short, we make every attempt to get them connected with services as soon as possible which attributes to such a high show rate. Not only that, but we find patients start and stay with us as 75% choose to remain in our care for greater than one year.
The Spero treatment team conducts both behavioral health and physical health assessments to determine if services are appropriate for each individual patient. Mr. Priest explained:
Occasionally, our team determines that the patient needs inpatient care and we will work with them to find the right location for the patient with one of our community resource partners. We also welcome pregnant women with the goal of providing appropriate care for both the mother and the unborn child in coordination with their OB/GYN physician. From time to time friends and family members of our patients will have unique needs too, and we offer family education and family services as a separate component of care if needed.
Future of addiction treatment
The integration of treatment to look at the “whole person” is a trend spreading through the different branches of health and human services, including addiction. With this in mind, Mr. Priest explained his vision of the future, and Spero’s place in it.
It has certainly changed dramatically in the last few years, as stigma starts to diminish. From our standpoint, we provide life-saving care for this patient population as everyday more than 115 people die in the United States after overdosing on opioids. Our mission statement is to “Save Lives, Instill Hope and Restore Relationship”, and feel we have a moral obligation to serve the communities we are currently in, and to grow to serve more communities. One of the reasons for choosing the name Spero Health is that the word Spero is Latin for “I hope.”
Our vision is to take our integrated care approach to addiction treatment, and the culture we have, which is built on community and family, and expand it to provide more care to more people, in more places. In America today, there are 2.6 million people with opioid use disorder, and only 10% are in treatment. To save more lives and to connect more people back to their loved ones, access to treatment needs to be available to more people.
I see a lot of community outreach and education in the future. Stigma has diminished significantly in the past couple of years, but there is more work to be done. I spent 16 years in kidney dialysis. In many ways, substance abuse treatment is where dialysis was in the late 1970’s. The American people are saying “we are tired of people dying from this disease and we are willing to pay for treatment”, so we must figure out how to increase access to care. Just a few years ago, most people did not even realize the problem existed and now it is the number one health care crisis in the United States.
Spero Health is an integrated healthcare provider offering comprehensive outpatient physician services, behavioral health counseling, recovery support services and patient education to people suffering from substance use disorder.
Year Founded: Founded in 2018, Spero Health is a newly formed healthcare organization headquartered in Brentwood, Tennessee with investment capital provided by Heritage Group, Health Velocity Capital, South Central Inc., and Frist Cressy Ventures. On February 1, 2018, Spero Health acquired 20 freestanding clinics located throughout Kentucky, Ohio, and Indiana and now provides care for more than 5,200 people every month.
5141 Virginia Way, Suite 390
Brentwood, TN 37027
- Steve Priest, President & Chief Executive Officer
- Rick Adams, Chief Financial Officer
- Dena Levine, Chief People Officer
- Mark Rappe, Senior VP, Development
- Jim Andrews, VP Revenue Operations
- Steve Duke, VP Information Technology
- David Hayden, VP Clinical Services
- Ginger Jackson, VP Marketing & Communications
- Matt Sirasky, VP Finance
- Spero Health has a network of 20 clinics in Kentucky, Ohio and Indiana, caring for more than 5,200 patients poised for growth to provide care to more communities in need as we care out our mission of “Saving Lives, Instilling Hope, and Restoring Relationships.”
- Spero Health combines both medical and behavioral healthcare services, bringing them together under one roof, laser focused on treating the whole patient suffering from substance use disorder. Services include: access to a physician, counseling, recovery supports and education all woven into individualized treatment plans designed around unique needs of each individual.
- Spero Health is committed to eliminating barriers to treatment and seeks strong partnerships in all communities served as well as with key payers and contractors who have a shared goal of increasing access to treatment. Our goal is to provide lifesaving care in a local and affordable environment.