Background: Federally Qualified Health Centers (FQHCs) can provide medication assisted treatment (MAT) to financially disadvantaged patients with opioid use disorders (OUD), but more research is needed to optimize integration. We conducted a pilot study of the Personalized Addiction Treatment to Health (PATH) model, which supplements existing MAT model with cognitive behavioral therapy (CBT), contingency management (CM) with financial rewards, and engagement with peer specialists. This study explores the PATH model from provider and patient perspectives.

Methods: A series of 18 semi-structured interviews were conducted with 10 staff members (4 MAT providers, 4 Behavioral Health Consultants, and 2 Peer Recovery Specialists) and 8 engaged patients treated with the PATH model across 4 participating FQHC sites (2 in Philadelphia, PA and 2 in Washington, D.C.). A thematic analysis examined staff communication, training logistics, patient experiences with PATH, and relationships between patients and clinical staff.

Results: Sampled patients reported an overall positive experience with PATH. Most commonly referenced benefits were relatable therapists and knowledgeable providers. Patients reported the monetary rewards from CM provided essential money for transportation to treatment and a motivational boost. However, providers gave mixed reports. While most viewed CM as useful for enhancing treatment retention, some providers believed CM was ineffective and disruptive to therapy. Providers reported benefits from adapting treatment protocols to individual patients’ needs and preferences. The sites struggled to fully integrate the peer specialist into many patients’ treatment plans, but patients generally found these relationships beneficial. Staff-wide communication was a crucial part of successfully implementing the integrated model.

Conclusion: Staff trainings should address the importance of provider relatability to patients, individualized patient treatment plans, and clinic-wide communication. Patient and staff perspectives are essential to refining the integration of OUD treatment into primary care.