Bicycle Health has teamed up with Wellpath and the Federal Bureau of Prisons to provide opioid use disorder treatment to incarcerated individuals.
Bicycle Health, the telehealth provider for OUD, will provide the care, while services will be reimbursed by Wellpath. Wellpath is one of the country’s largest providers for prisoners and other vulnerable patients. Services will be available to individuals living in halfway houses known as residential reentry centers (RRCs) across 42 states with plans to expand.
Telemedicine is a great way to provide care to these individuals because it facilitates continuity of care with the same provider during incarceration and after, Bicycle Health founder and CEO Ankit Gupta told Fierce Healthcare. That engagement “is extremely important. I think that’s going to directly reduce the risk of overdose,” he said.
But providing care in this setting is not without its complications. Though individuals in RRCs typically have access to a phone and internet, there is a lot of variation, Gupta noted. That’s why the company has been authorized by the bureau to provide audio-based treatment in cases where video is not an option.
Other nuances run the gamut, from variations in drug testing to the way prescriptions are filled.
“We’ve actually had to sort of adapt our model to this patient population,” Gupta said.
For instance, patients cannot go to a pharmacy or use insurance. Bicycle Health must work with RRC case managers to get patients a voucher for each prescription, which must be approved by the bureau. That necessarily means getting prescriptions will take a lot longer and involve a lot more care coordination and patient monitoring, Gupta explained. Bicycle Health clinicians are being trained internally by a staffer with experience in criminal justice healthcare, Gupta said.
Medications for OUD like buprenorphine have been found to be significantly underutilized in criminal justice settings. The goal of the latest partnership is to improve access to and promote clinically appropriate use of this type of treatment, the companies said in an announcement, and improve not only health outcomes but also reduce recidivism.
“Telehealth is now well understood to be a widespread, highly effective treatment delivery option for patients with opioid use disorder, which is why we chose to work with Bicycle Health. In doing so, we’re able to overcome many of the obstacles that prevent formerly incarcerated people from getting the MOUD treatment they need,” Thomas Pangburn, M.D., chief clinical officer at Wellpath, said in a press release. “This collaboration helps streamline the process for re-entry by providing evidence-based and convenient treatment options, which can make a real difference for those struggling with opioid addiction.”
This model could, however, be at risk if the public health emergency ends without changes to the Ryan Haight Online Pharmacy Consumer Protection Act. Last Friday, the Drug Enforcement Administration (DEA) proposed changes to COVID-era telehealth rules mandating in-person appointments for virtual prescriptions of controlled substances.
“This rulemaking unnecessarily limits access at a time when it’s needed the most and puts thousands of lives at risk,” Gupta said in a statement in response to the proposed rules. “We plan to work with the DEA during the public comment period toward common sense revisions.”