Primary care provides medication for opioid use disorder: findings from the HOMER study.

Context: Changes in regulations related to medication for opioid use disorder (MOUD) have expanded access to MOUD in primary care. However, there has been concern that primary care practices are unwilling or unable to treat patients with OUD. Objective: To describe the practices and patients enrolled in the Patient-Centered Outcomes Research Institute (PCORI)-funded HOMER (Comparing Home, Office, and Telehealth Induction for Medication Enhanced Recovery) research study who delivered MOUD as part of routine primary care practice. Results: A total of 79 practices from 25 states expressed interest in participation. Sixty-two practices signed up for HOMER. Practices were typical of US primary care, accepting a variety of payers, including commercial insurance, Medicaid, Medicare, and uninsured patients, and caring for patients of across a spectrum of adult ages, races and ethnicity, education, and income. The majority had health insurance (82%). Most patients reported using prescription opioids (59%), while 41% reported other opioid use. Greater than 40% of participating patients reported no prior medication treatment for OUD. Conclusion: The finding that nearly half of patients had no prior treatment supports the importance of primary care as a crucial component of MOUD. Practices in HOMER were similar to practices across the country. Patients enrolled were typical of family practice patients. Policies that support primary care MOUD may improve access to patients.