Table 2.
Condition | Description of condition | Calibration | Rationale |
---|---|---|---|
Providing MAT | Extent to which the practice has at least one medical provider providing MAT to patients at that clinic | 1 = providing MAT fully with systems in place 0.8 = generally providing but is still bumpy, erratic 0.6 = quietly providing MAT but not much or not advertised 0.2 = did a few and stopped 0 = not providing MAT |
Outcome of interest |
Practice Size | Small practice = 1–2 medical providers; Medium = 3–5; Large = 6 or more | N/A. Practice size was used as a contextual condition with separate QCA analyses for small, medium, and large practices | Size may have an effect on ability or interest in providing MAT |
Private practice | Practice is owned privately by the physician or medical provider or those in the practice | 1 = private practice 0 = practice is owned by a hospital |
This practice structure may operate differently than others |
Clinician with MAT Experience (Clinician) | At least one medical provider (with prescribing authority like a physician or APP) has had exposure to or themselves provided MAT before either at this practice or elsewhere | 1 = had experience providing MAT themselves 0.8 = has experience with observing MAT being provided in own practice 0.6 = has had some exposure in their training but has not provided it themselves or in own practice 0 = has not experience or exposure to MAT |
Those who have already provided MAT makes for 1) mental switch of being willing to do it and 2) hurdle of having done it already so easier on-ramp to doing again; exposure maybe more willing to consider doing it Some practices might have a MAT prescriber with experience (or a waiver) who is choosing NOT to prescribe |
MAT prescriber on staff (Prescriber) | Practice has a clinician with a DEA waiver | 1 = Clinician with DEA waiver to prescribe MAT at practice 0 = No clinician with DEA waiver to prescribe MAT at practice |
Some practices might have a MAT prescriber with experience (or a waiver) who is choosing NOT to prescribe |
Behavioral Health in the Practice | Having at least a part-time person physically located in the practice that provides mental and behavioral health support | 1 = BH in the practice at least part-time regardless of employment and has a least some capacity to take on MAT patients 0.6 = so occasional and already overbooked that no capacity to take on MAT or very occasional BH in the practice and not familiar with MAT 0 = no BH in the practice even if have referral source |
Since many perceive BH support as a needed component to providing MAT, this may make a difference in willingness to do it |
Leadership Buy-in for MAT | The extent to which leadership at the practice and health system level (if applicable) is supportive of providing MAT | 1 = strong leadership support across range of leaders with emphasis on major decision maker(s) 0.6–0.9 = range of generally having support 0.1–0.4 – range of generally not supportive 0 = no leadership support or blocking efforts to do MAT |
When leadership is not in support, then the practice often cannot move ahead with providing MAT |
Practice Champion or Key Person | The presence of a person who was in charge and made things happen for the MAT efforts; usually person with passion, but does not have to be | 1 = had champion <0.5 = not strong champion—someone voluntold to do it/no passion/capacity 0 = no champion |
If there is someone there whose job it is to get MAT going, this could influence progress on making it happen |
MAT system in place | Extent to which the practice has some way of having their patients get to MAT help. A formal MAT system included identification of patients suffering OUD along with referral or treatment, behavioral health support/referral, peer support or referral, and follow-up plans | 1 = providing MAT directly or have strong and consistent referral partners that their patients get referred to (including follow-up) 0.1–0.45 = range of having some referrals but not consistent or strong or not MAT-specific 0 = neither in place |
If they have a way to refer to or provide MAT, this affects the outcome of getting patients to MAT |