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Ophelia is a digital treatment program for opioid addiction
Steven Loeb speaks with Zack Gray, co-Founder & CEO of Ophelia, a digital treatment program for opioid addiction.
Ophelia, which is currently licensed to operate in 27 states and has insurance contracts covering 75 million people, operates seven days a week. The company began providing care to its first patient in 2020, and since then it has grown 6x year-over-year.
In December, the company raised a $50 million round of funding, bringing its total capital to $68 million.
Our overall goal with these podcasts is to understand how technology is radically changing healthcare: the way we screen, treat and measure progress and outcomes. How we’re empowering the consumer. Whether we’re creating productivity that drives economic costs down? And how tech advancements change the role of the doctor.
Highlights from the interview:
- Gray started Ophelia after a girl he was close to died of an opioid overdose in 2019. What he learned is that the difficulties are not medical or scientific, they're mostly related to access of care: 80% of Americans with opioid use disorder are not getting any treatment at all.
- To prescribe medication, clinicians need a separate license administered by the DEA called an X waiver, which only 5% of clinicians have. Once they get one, they are capped in the number of patients they can treat, which is only 30 in the first year, meaning that they aren't eligible for a full time job in an addiction treatment program, so most go work elsewhere and never treat any patients at all.
- Ophelia has created a team-based care model where patients are paired with a prescriber, a nurse care manager, and a care coordinator. That means the patient can get round the clock attention from their care team. The company also built out software and a training program, and it provides all the legal and reimbursement infrastructure to make it economically viable for clinicians to treat patients, who can use telemedicine to get care directly in their home, without disruption to their daily life.
- About 70% to 80% of patients on Ophelia don't regularly see a primary care doctor, which means the company is their only touch point to the healthcare system. While Ophelia also treats mental health conditions, including depression and anxiety, right now it isn't able to treat other physical health conditions. However, the company is planning to eventually build out a network of providers so it can treat those other conditions in the future.
- There is very little to be gained for in-person care for most patients. Some patients aren't suited for a digital-only platform because they need to be medically stabilized in person before receiving treatment but, for the most part, opioid detox is not dangerous, it's just uncomfortable. Most of the protocol can be delivered as well, or better, through telemedicine.
- Community is hugely important in addiction treatment, and it's something that Ophelia has started to build out. Today patients get counseling and talk therapy from their clinician, and the company also has peer coaches who can chat with them, but it hasn't yet started fostering community among patients. This is something it wants to invest in as it builds out its program.
- Opioid overdose was already the number one cause of death for Americans under 50 before COVID, and the problem is only getting worse thanks, in part, to layoffs and people having less to do; idle time can be a trigger for addicts to start using again. There was also isolation and psychological issues that comes with not having a source of income. Also, traditional treatment programs started to go bankrupt or downsize, and there was a decrease of eligible subscribers.
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