Objective: To conduct a customer discovery analysis (stakeholder engagement) to formulate a value proposition to inform the implementation of the MAT expansion.

Methods: We used in-depth interviews to define the MAT expansion value for target stakeholders (pilot and prospective adopters) and community partners, and process mapping to understand policy and organization structure. Qualitative data was integrated using independent coding and inductive thematic analysis.

Results: Twenty-two semi-structured interviews were conducted with the following customer segments: pilot and prospective adopters (administrators, providers, Behavioral Health Consultants, case manager) across Colorado; and community leaders (i.e. community advisory boards) and organizations serving rural CO. We integrated lessons learned from the pilot with the new needs assessment. Major themes included (1) Increasing provider and community OUD education to decrease stigma; (2) Coordination of care and connection to resources (3) More efficient electronic data reporting system, and (4) Support to overcome barriers. Insights led to the creation of a toolkit with clinical guidelines, the implementation of an efficient electronic data reporting systems, and continuous technical/clinical support.

Conclusions: By bringing value for target adopters and partners, the analyses informed the MAT expansion into rural areas with high prevalence of OUD, serving as a platform to develop similar approaches for assessing services in resource-limited areas. More research is needed to understand how this quality improvement process affects OUD patients’ engagement, adherence, and treatment outcomes.