Tackling Big Problems

Groups’ approach to treating OUD lowers the mortality rate by 75% and reduces total cost of care by 37%.
Published:
December 2024
THE PROBLEM

OUD continues to be a significant public health issue. Existing treatments are failing to meet patient needs as the number of opioid-involved overdose deaths continues to reach new heights.

  • As of 2022, ~3.7% of U.S. adults aged 18 and older needed treatment for OUD. This translates into roughly 9.2 million people.
  • Only ~25% of those who needed treatment received medications for OUD.
  • In 2023, there were over 81K opioid-involved overdose deaths in the U.S.

Those seeking treatment at Groups have diverse needs that are significantly more complex than typical outpatient populations:

  • 85% have problems with other substances (85% cigarettes, 31% stimulants, 28% alcohol, 9% benzodiazepine)
  • 39% have co-occurring serious mental illnesses
  • 62% have health-related social needs that pose barriers to recovery
  • 20% are involved with the criminal justice system
  • 12% are at high risk for suicide
A SOLUTION THAT WORKS

Groups has built a comprehensive treatment model that combines evidence-based care, community accountability, and social support delivering industry-leading outcomes for both patients and health plan partners.

Evidence-Based Medicine. Everything is based on the latest clinical evidence to ensure strong outcomes.

  • 100% of members received evidence-based medications for opioid use disorder (MOUD) vs. 22% at other treatment programs nationwide.

Community-Powered Recovery. Overcoming addiction is hard, but doing it alone is even harder. Groups orients its clinical model around the power and accountability of community.

  • 100% of members received regular counseling and psychological support vs. 26.6% at other treatment programs nationwide.

Whole-Person Care. Addiction is about more than substances, and recovery is about more than sobriety. Groups is committed to helping members find hope, recovery, and wellness in all areas of their lives.

  • 58% of members received support for health-related social needs (housing, insurance coverage, primary care access, behavioral care access, social support, transportation, finances, employment, food, childcare and legal support) vs. 6.9% at other treatment programs nationwide.

Value-based Contracting. Groups aligns incentives with plans using a replicable, value contract structure with premium bundled payment tied to the achievement of clinical proxies for cost and provider (vs. vendor) contracting, allowing payment through claims systems.

  • Total cost of care reduced for health plan partners by 37%, based on case studies of Groups members vs. matched controls.
OUTCOMES THAT MATTER

Groups’ results speak for themselves:

  • 6-month retention rates at 3x the national benchmark.
  • Rates of toxicology-confirmed opioid remission at ~2x the national benchmark.
  • All-cause mortality rates approximately 2x better than the national benchmark.
  • More than 15K members assisted with important needs like housing, employment, education, and access to social support.
  • Quality of life improvement by an average of 32% across key domains like physical health, mental health, sleep quality, and social relationships.
“Groups’ holistic approach to opioid use disorder treatment matches MDwise’s focus on delivering whole-person, high-quality care for Medicaid beneficiaries, especially in rural areas of Indiana. Together, we’re addressing the whole member rather than focusing just on the addiction.”

Jessica Cromer, CEO of MDwise, an Indiana-based health insurance plan focused on vulnerable populations

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