I Have No Financial Disclosures 50 INCREASE in

“I Have No Financial Disclosures”

Ø 50% INCREASE in OVERDOSE DEATHS DUE to SYNTHETIC OPIOIDS (FENTANYL)

COVID 2020

94% NYL A T N E F 20%

CHAPMAN, MD, PC EAST WEST

WEST at n o rti o p pro Black s i D y Disproportionatel y White el EAST

HOMELESS with OPIOID USE DISORDER: DEATHS 2016 -2020 0% 20

REVERSE ENGINEERING 401 YEARS of SYSTEMATIC OPPRESSION MASS INCARCERATION COMMUNITY REINTEGRATION #ASAM 2021

CHAPMAN, MD, PC 230 Current Patients on Buprenorphine: np r

WASHINGTON, DC as a Generic Exemplar

BUPRENORPHINE MEDICATION DIVIDE

Federal Register November 2, 2020 ANNUAL NET SAVINGS to the FEDERAL GOVERNMENT by EXPANDING BUPRENORPINE TREATMENT NPs, PAs, etc

$7, 500 ANNUAL BUPRENORPHINE TREATMENT COST SAVES MONEY $42, 000 UNTREATED ANNUAL MEDICAL COSTS Edwin C. Chapman, MD, PC © 2021

TOTAL IMPACT of an INDIVIDUAL PATIENT on COMMUNITY PATIENT IN TREATMENT UNTREATED PATIENT Criminal Costs INCREASED JAIL & CRIMINAL JUSTICE COSTS SILOED COSTS DECREASED JAIL & CRIMINAL JUSTICE COSTS $35 K TOTAL COST $112 K INCREASED ED & HOSPITALIZATION HIV & HEP C COSTS $42 K Medical Costs EDWIN C CHAPMAN, MD © 2017 Every $1 Spent on Treatment Saves $7 INCREASED COMMUNITY CRIME, UNEMPLOYMENT POOR SCHOOL PERFORMANCE, FAMILY DYSFUNCTION $35 K Social Costs DECREASED ED & HOSPITALIZATION HIV & HEP C COSTS INCREASED MAT OPIOID DRUG Rx $50 -60 K With Rx DECREASED COMMUNITY CRIME, UNEMPLOYM’T, POOR SCHOOL PERFORMANCE, FAMILY DYSFUNCTION COST SAVINGS

HARM REDUCTION-LOSS MITIGATION MODEL using MEDICATION for OPIOID USE DISORDER (MOUD) UNITERUPPETED DRUG USE NO TREATMENT = $112 K TOTAL COST Criminal Justice $35 K Social Economic $35 K Medical & SUD $42 SIGNIFICANTLY REDUCED DRUG USE HARM REDUCTION with MOUD = $52 K NET SAVINGS Criminal Justice $10 K Social Economic NO DRUG USE COMPLIANT with MAT = $62 K NET SAVINGS $30 K Medical & Criminal Justice Social Economic Medical & SUD $0 $30 K $20 K Edwin C. Chapman, MD Chief Medical Officer Medical Home Development Group © 2018

RYAN WHITE CARVEOUT KNOWLEDGABLE SPECIALTY NETWORK $ $

MOUD TREATMENT CARVEOUT KNOWLEDGABLE SPECIALTY NETWORK $ $

PRIOR AUTHORIZATIONS for BUPRENORPHINE IMPEDES ACCESS to CARE and INCREASES ED VISITS and HOSPITALIZATIONS

FRAGMENTED PAYMENT SYSTEM IMPEDES VALUE-BASED CARE OFFICE BASED MOUD

LEANA WEN, MD, MPH FORMER BALTIMORE COMMISSIONER of HEALTH February 2016