Institute for Behavioral Health

Washington Hub & Spoke Model to Improve Pharmacotherapy Use for Opioid Use Disorders and Promote Recovery

Project Overview

The federal government, through SAMHSA’s Opioid State Targeted Response (Opioid-STR) grants, has provided funding to each state to ramp up the range of responses in hopes of reversing the ongoing opioid crisis. Washington State has implemented a “Hub & Spoke” integrated care model to expand access to pharmacotherapy services (also known as medication-assisted treatment, or MAT) and reduce unmet need for people with opioid use disorder (OUD), regardless of how or where clients enter the treatment system.

Hub diagram

Complementing the SAMHSA state grants, the Institute for Behavioral Health at Brandeis University’s Heller School for Social Policy and Management was funded by the National Institute on Drug Abuse to assess the effectiveness of approaches to expand MAT for OUD in the general health care sector in Washington State.

SAMHSA Grant vs. NIDA Grant

The findings from this study will enable us to understand the essential elements of the Washington State Hub & Spoke model for the most effective outcomes related to pharmacotherapy for opioid use disorder (OUD), and how to bring more primary care providers to the addiction pharmacotherapy practice. It will serve as a model for other states and systems, offering a flexible approach that addresses many existing barriers to the use of pharmacotherapy for people with OUD, ensuring that there is no wrong door to enter treatment, and that people with OUD receive the treatment with the best success for promoting recovery.

Employing a Hybrid Approach in Our Research

This research project uses a hybrid design to study both implementation and effectiveness of the Washington State Hub & Spoke model. The study will evaluate the effectiveness of the Hub & Spoke model and simultaneously gather information to understand its implementation. By braiding the implementation and effectiveness studies, we should reduce the time needed for future uptake of the Hub & Spoke model, building on the key aspects for effective implementation. With each WA Hub & Spoke network designing its own approach, it is important to understand what Hub & Spoke looks like within and across networks. Ultimately, we want to know if Hub & Spoke is successful in increasing access to OUD medication treatment, and if people treated in the Hub & Spoke model have better outcomes. 

Research aims of Hub & Spoke project