Ideal Option and PacificSource Announce Ground-breaking Value-Based Payment Model for Office-Based Opioid Treatment in Oregon


Substance use and overdose deaths increased at an alarming rate in Oregon during the pandemic. According to the Oregon Health Authority, the state saw a nearly 70% increase in the number of overdose deaths during April – May 2020 compared to the same period in 2019. Fentanyl has been the primary driver of this uptick due to its pervasiveness in the illicit drug supply. Provisional data from the CDC show a 159% increase in synthetic opioid overdose deaths in Oregon from November ‘19 to November ‘20.

Based on Ideal Option’s own lab testing data, collected from patients across its five clinics in Oregon, there was a 173% increase in patients testing positive for fentanyl at enrollment in April ‘21 compared to April ‘20. More recent data collected in 2021 show the alarming trend continuing. In May ‘21, 55% of patients tested positive for fentanyl at enrollment, a 157% increase compared to January ’21.

Despite skyrocketing substance use and a desperate need for treatment in the state, specialty outpatient providers like Ideal Option, which has provided treatment to Oregon patients since 2018, began encountering major financial barriers in 2020. Reimbursement for treatment and lab services dropped to an all-time low, making it difficult for Ideal Option to continue to provide evidence-based treatment and cover its operational costs.

“Our Oregon clinics have been operating on a shoestring budget, and it was necessary to close two clinics last year,” said Tim Kilgallon, CEO of Ideal Option. “But now, thanks to PacificSource’s innovative approach to population health, we’re ready to expand and invest in the state again. Overdose deaths will be prevented, and thousands of Oregonians with substance use disorder will be given a chance to rebuild their lives.”

The new alternative payment model fixes monthly per patient cost, objectively measures population outcomes, and eliminates restrictive and administratively burdensome procedure-based payment. The resulting simplification is expected to provide measurable savings and give Ideal Option providers freedom to customize service delivery to optimize clinical outcomes for each individual patient.

It is the first payment model of its kind in Oregon for office-based opioid treatment and will hopefully inspire other state and commercial payors to follow suit. Until that happens, Ideal Option’s expansion plans in Oregon are limited to PacificSource’s coverage areas.

“As a not-for-profit family of companies, PacificSource puts its members and their needs first,” said Mike Frantz, MD, medical director of behavioral health at PacificSource. “Our company actively seeks out initiatives to advance social justice, equity and inclusion in the healthcare system, so when we saw an opportunity to pursue a value-based payment contract for opioid treatment with Ideal Option, we jumped at the chance to find an innovative, equitable solution.”

Ideal Option is ready to welcome new PacificSource patients in Eugene, Salem, and Bend. With no waitlists, new patients can typically get started on evidence-based treatment for fentanyl, heroin, methamphetamine, alcohol or other substances within 1-3 business days.

Patients can make an appointment by calling 1.877.522.1275 or visiting http://www.idealoption.com

About Ideal Option 

Headquartered in Kennewick, Washington, Ideal Option was founded in 2012 and has since helped nearly 45,000 patients through a network of almost 70 office-based medication-assisted treatment (MAT) clinics across 10 states. With a mission to serve under-served communities, Ideal Option accepts all forms of insurance including Medicaid and Medicare. Financial assistance and payment plans are also available. 

Ideal Option’s team of medical providers carry certifications in Addiction and Emergency Medicine, Internal, OB/GYN, and Family Medicine, among other specialties. The company also employs social workers, caseworkers, counselors, and mental health practitioners. This holistic approach helps drive positive outcomes, including family stability, stable housing, improved overall health, and reduced rates of recidivism. 

In all the communities it serves, Ideal Option collaborates with existing stakeholders and providers to improve the continuum of care. This approach includes partnerships with emergency rooms and county jail systems, where individuals with substance use disorder often appear, as well as collaborating with numerous support agencies and municipal programs addressing social needs such as housing, mental health, and nutrition support.

About PacificSource Health Plans

PacificSource Health Plans is an independent, not-for-profit community health plan serving the Northwest. Founded in 1933, PacificSource has local offices throughout Oregon, Idaho, Montana and Washington. The PacificSource family of companies employs more than 1,500 people and serves over 523,700 individuals throughout the Greater Northwest. For more information, visit PacificSource.com.

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