ELLSWORTH — They didn’t want it to feel like a doctor’s office, explains Jocelyne Wood, regional manager for addiction treatment center Groups Recover Together.
That’s in part why the walls of the Ellsworth location are painted a deep teal, the rooms are adorned with bright orange and yellow chairs and there are white boards scrawled with acronyms for relapse prevention.
“It’s always complicated to say it’s going well given the work that we do,” said Groups Executive Director Cooper Zelnick.
“I wish that there weren’t as much need as there is, of course, but we feel really lucky to be making an impact in Ellsworth.”
Since opening a little more than two years ago at an unadorned space in the Mill Mall, the for-profit treatment center now serves more than 250 clients each week from its current offices off the Beechland Road.
Groups, which now has locations in eight states, opened its first clinic in March of 2014, the brainchild of then-Dartmouth medical student Jeff DeFlavio. The goal was to reduce barriers to treatment, namely cost and distance, especially for uninsured patients in rural areas where the nearest clinic might be hours away.
At Groups, for $65 per week, patients get a prescription for Suboxone (the prescriptions are filled at area pharmacies, not on-site), unlimited visits with a medical provider and group counseling.
Medication costs an additional $40 to $80 per week for those without insurance, depending on dosage, said Wood, and patients are encouraged to come back for counseling after they “graduate” for as long as they need, for free.
In Ellsworth, roughly 70 percent of Groups members are covered by MaineCare (Maine’s version of Medicaid), said Zelnick, which pays for the cost of medication. Another 20 percent are covered under private insurance, and 10 percent are uninsured or pay privately.
The company also has some funding to help cover the cost of treatment for those without insurance, said Wood, and can connect patients with resources to help defray the cost of medication.
The Silicon Valley startup approach to addiction treatment seems to be working. Where small nonprofits have struggled to find consistent funding and work with scant resources, Groups has continued to grow.
The company has garnered funding from several venture capital firms and groups such as Kaiser, Optum and the California Health Care Foundation, Zelnick said.
In a little more than five years, Groups has opened more than 50 clinics in eight states. It serves more than 5,000 patients every week nationwide and plans to open up an additional 10 offices this year, said Zelnick, with a focus on states such as West Virginia, Kentucky and North Carolina.
“Our goal is to bring evidence-based, affordable care to those who need it with a focus on rural areas,” Zelnick said.
In Maine, Groups has at least two state contracts. Its newest is a contract with the Maine Department of Corrections to provide addiction treatment services to inmates as part of a year-long pilot program that began in July.
Groups is also one of the dozens of providers contracted with Maine Department of Health and Human Services to serve as “Opioid Health Homes,” an initiative of the LePage administration aimed at uninsured patients and those covered by MaineCare. Despite the name, opioid health homes provide outpatient, office-based care.
The homes are a team-based approach that includes office visits, counseling, medication, and referrals to community and social support services. There are more than 30 providers contracted with the state to provide these services, all of which are reimbursed under a tiered rate structure.
Groups’ Opioid Health Home contract is valued at $1,637,380. Under that contract, the company is reimbursed by the state for providing a bundle of services to clients each month.
How much it is reimbursed depends on what a client’s needs are: for patients who require the most intensive level of care, Groups is paid $2,721 per patient per month. That drops to $1,549 per month for a patient who requires an intermediate level of care, to $1,666 for a maintenance level of care and to $504 per client per month for the least-demanding level of care, those who require only a prescription for medication.
Groups has opened its recovery centers in 10 Maine communities stretching from Calais to Biddeford. By next year, it plans to open locations in Bangor, Belfast, Houlton and Rumford, Zelnick said.
Each office employs several licensed substance abuse counselors and contracts with local medical personnel for checkups and to prescribe medication.
No medication is kept on site, which helps keep overhead costs low, as Groups centers aren’t required to pay for security and adhere to additional regulations.
Zelnick is aware of the public skepticism of a for-profit enterprise providing care to a vulnerable population.
“I like to say that all health care is for profit,” Zelnick said. “It’s just a question of who’s profiting.”
“To confine this work to the realm of government and charity means we will never catch up, forever one step behind,” states the Groups website.
Groups is profitable in Maine, said Zelnick, although it is not yet profitable overall.
“We made the decision to pursue a for-profit structure for one reason,” Zelnick continued, “which is that our belief and hope is that that would allow us to grow more quickly and serve more communities of high need.”
Maine Director of Opioid Response Gordon Smith said he isn’t overly concerned with the fact that the state has contracted with a for-profit group to provide services.
“This is America. People can provide the services that they’re qualified to provide in whatever mode or format,” said Smith. “Medicine is really practiced in many contexts in a for-profit environment — whether it’s at the pharmacy or a medical provider’s office.”
Smith continued: “As long as they’re compliant with the same laws and regulations that all other providers of medication-assisted treatment have to observe then who is the state to suggest that simply because they’re for-profit that that is a bad thing?”
Smith said he was more concerned by one entity serving a large portion of the population.
“I’m more troubled by the fact that they have such a large percentage of the market share that if they were to leave the state it would leave a lot of people scrambling,” Smith said.
Correction: an earlier version of this story contained an error. Jocelyne Wood is regional manager for addiction treatment center Groups Recover Together.