In 2018, the New Hampshire Department of Health and Human Services won a $45 million grant to help fund a new statewide system for curbing opioid addiction. The new “hub and spoke” program, which kicked off on January 1, creates an organized network of treatment providers for those battling addiction.
How it works
There are nine opioid treatment “hubs” — most of them hospitals — where those seeking treatment can find immediate care. Patients who arrive at hubs are given initial screening, assigned a case manager, and, if necessary, started on medication-assisted therapy.
From there, these patients are referred to impatient detox centers, recovery housing or other community resources to address their needs. These secondary treatment services are the “spokes” of the hub and spoke model.
One challenge for New Hampshire’s hub and spoke system has to do with the shortage of behavioral health care providers. Vermont, which has pioneered the hub and spoke system for the past five years, has had difficulty extending treatment options to rural parts of the state. New Hampshire may struggle with similar issues.
Part of that shortage is due to low Medicaid reimbursement rates. When a Medicaid patient seeks mental health care, New Hampshire reimburses mental health providers at around 58 percent of what commercial carriers do. New Hampshire’s Medicaid reimbursement rates are also much lower than the national average.
Some also fear the hub and spoke model will draw attention and funding away from existing programs, like Safe Stations.
Opportunities to make progress
Proponents point to the overall success Vermont has enjoyed using the hub and spoke system. The state has demonstrated an improved ability to handle the influx of opioid addiction cases. New Hampshire health officials see the hub and spoke method as a way to organize what has been a chaotic system for treating drug addiction. They believe this system, which creates a path from immediate intervention to long-term care, will result in fewer patients falling through the cracks. They also hope it will increase opportunities for treatment outside Nashua and Manchester.
Learn more about NH’s new drug treatment system
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