The Challenge

In 2018, Meritus Health, the largest health care provider in western Maryland, called upon the Mosaic Group to develop a customized opioid response plan for Meritus Medical Center’s emergency department. 

Like many states, Maryland had experienced a surge in opioid use. In 2017, the governor of the state had declared a state of emergency due to the opioid epidemic. The rural area served by Meritus was no exception. The hospital emergency department had seen significant increases in opioid overdoses. 

How We Helped

Mosaic Group developed a customized program which integrated universal screening, peer response, and overdose intervention programs and developed community-based support.

In 2019, medication for opioid use disorder (MOUD) initiation was incorporated into the ED. One dose of buprenorphine was provided to patients who were ready to begin treatment and continue with ongoing, community-based care. However, there were still significant gaps in care associated with patients getting access to MOUD—in particular, none of the ED medical providers had obtained their X waiver and, instead, administered medication under the DEA 3-Day rule. 

Our Impact

In 2022, Mosaic Group helped Meritus Medical Center refine its efforts and implement an MOUD Bridge Prescribing Protocol. An important component of this protocol was to helping Meritus’ ED medical providers submit a Notice of Intent (NOI)—following new guidance from SAMHSA—in order to receive X waivers. As a result, 82% of the ED providers at Meritus received the X waiver which significantly increased patient access to medications and treatment.