Pelago Expands Substance Use Management with Launch of Inpatient Centers of Excellence Network

Move Addresses the Nearly 50% of Inpatients Who Don’t Complete Costly SUD Treatment While Delivering a Trusted Lifeline for Those in Need

 

NEW YORK, NY – June 6, 2024 – To address rising substance use disorder (SUD) costs, barriers to appropriate care, and low inpatient treatment completion rates, the Pelago digital substance use management clinic has launched a first-of-its-kind Centers of Excellence (CoE) network. Among the partners joining the nationwide inpatient network are Recovery Centers of America, and Banyan Treatment Centers. Pelago becomes the first digital substance use treatment provider for tobacco, alcohol, opioids and cannabis with a network of pre-vetted inpatient treatment centers that completes the SUD care continuum. 

“Members in urgent need of high-acuity care have to deal with an incredibly complex, difficult-to-access system plagued by multiple barriers to care,” said Yusuf Sherwani, M.D., Co-founder and CEO of Pelago. “These barriers range from a lack of expert guidance via employer or EAP referral, to the impossible task of assessing inpatient care quality and appropriateness, to communicating a leave of absence to one’s employer.” 

A Trusted Lifeline

Of the nearly 2 million people age 12 and over in the U.S. admitted to rehab centers each year, almost 600,000 are inpatient, receiving residential and detox services. Of that 600,000, a staggering 45% do not complete treatment. And U.S. Department of Health and Human Services (HHS) research found the largest source of inpatient treatment referrals (HHS dataset table 2.8b) was self- or individual referrals (44 percent). Astonishingly, only 1% of those seeking SUD inpatient care get referrals from their school, employer or employee assistance program (EAP). 

“Working with patients trying to recover from SUD on a daily basis, I see and hear how incredibly challenging it is for those needing a higher level of care to find the right fit from a vast array of inpatient treatment centers and options,” said Justin Yang, MD, MPH, FACP, Medical Director at Pelago. “That’s why each network partner undergoes a rigorous assessment process to ensure they can deliver the appropriate care, including passing our proprietary outcomes and performance evaluation that includes meeting the highest levels of accreditation, licensure, clinical results, and training, and achieving best practices in quality metrics reporting and data sharing.”

By extending its clinically validated, specialized SUD treatment successes to inpatient centers of excellence, Pelago offers members and their employers a trusted lifeline on the path to dramatically increased completion rates and improved outcomes.

Integrated Substance Use Care

To deliver end-to-end care, Pelago starts with its SUD-specific front-door approach and proprietary clinical vetting process to identify those members in need of a higher level of care. The company then matches the member with a high-quality inpatient facility best-suited for them, provides a seamless transition for the member to the facility with white-glove service, and upon discharge, continues to support the member to prevent relapse and readmission.

“We are truly excited to partner with Pelago to meet patients where they are and offer a higher level of care when needed in our clinical centers of excellence,” said Brett Cohen, Chief Executive Officer at Recovery Centers of America (RCA). “With specialized inpatient and outpatient treatment programs at our 11 locations across the country, RCA’s team of doctors, nurses and therapists treats each patient with compassion, dignity and respect. We look forward to extending our clinical expertise and healing environment to the Pelago community.”

“We are thrilled to become a part of the Pelago Centers of Excellence network,” said Dr. Darrin Mangiacarne, Chief Medical Officer for Banyan Treatment Centers. “When Pelago members need more intensive care, our 17 locations across the country can seamlessly complement Pelago’s personalized approach. Our unique and innovative treatment programs have been meticulously designed to support patients at every single step of their recovery process, ensuring their utmost well-being and success.”

With a proper clinical referral and care management pathway ensuring the right level of care, employers can realize higher rates of successful SUD treatment completion. Research shows this translates into healthier employees and greater opportunity for cost savings and productivity increases. Once an employee is in recovery, annual missed workdays drop to 9.5 (lower than the general population), down from 29 days pre-recovery for opioid use disorder. 

Cost Savings and Quality 

A shocking 2021 national study of residential treatment programs found that one-third of prospective patients were offered admission before any clinical evaluation, usually within one day, without assessing appropriateness for other care settings. Pelago’s internal claims analysis has demonstrated that more than half of first-time rehab admissions could be avoided if properly assessed by a qualified provider, thus reducing unnecessary referrals and saving costs. 

To address the high cost of out-of-network SUD admissions, Pelago works with our partners to drive in-network utilization via their extensive insurance plan coverage. The ultimate goal is to ensure members receive the right level of care at the right time, and when a higher level of care is called for, refer them to thoroughly pre-vetted, high-quality centers of excellence. 

Employers, their populations and facilities all benefit from Pelago’s CoE ecosystem. Employers gain hard cost savings by eliminating unnecessary admission fees, accruing claims cost efficiencies, and reducing losses stemming from re-admissions and incomplete treatment. Because recovering employees represent the healthiest and most productive class of worker, productivity increases, absenteeism decreases and workplace risk is reduced. Employees needing a higher level of care receive the guidance and expertise they need to access coordinated care and return to work healthier and happier, and facilities gain from more qualified patients and higher completion rates. 

To learn more about our centers of excellence program, contact a member of our team. Inpatient treatment centers interested in partnering with Pelago to broaden their treatment footprint can contact our clinical team.