People often ask me how Wayspring engages and cares for members with substance use disorder (SUD) and complex behavioral health needs. The reality is, under traditional fee-for-service reimbursement models, it’s nearly impossible. There’s no CPT code for outreach, persistent relationship-building, or addressing essential needs like transportation, housing, or food. Yet, these are precisely the activities that transform lives.

A recent case study vividly illustrates why our approach works—and why it's critical. Over 16 months, our care team had 71 different interactions or attempts with an individual who was struggling with opioid and stimulant use disorders, severe mental health diagnoses, frequent hospitalizations, overdoses, and incarceration. Conventional systems might label this individual “non-compliant,” a term that oversimplifies complex lives and dismisses the structural barriers these individuals face.

At Wayspring, our care model approaches individuals very uniquely. Because we assume full financial responsibility for an entire population, we never have the luxury of giving up. Every unanswered call, every missed appointment, every relapse necessitates trying harder.

This member’s journey was arduous, filled with setbacks that could have easily derailed his engagement permanently. But we persisted. When he struggled to keep appointments, we continued to reschedule, conduct reminder calls, and help with cell phone access. When basic needs like clothing became barriers, we helped address them directly. And after a prolonged period marked by incarceration, return to use, and crisis interventions, our unwavering presence led to a breakthrough.

Today, this member is actively re-engaged in services for behavioral and physical care, as well as substance use disorder treatment, receiving Medication for Opioid Use Disorder (MOUD), and accessing vital community resources for employment and housing. This is what care looks like when it's free from traditional constraints—a model built entirely around what individuals truly need on an ongoing basis.

Download the full Wayspring case study now to explore these insights in depth.

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Frazer Buntin is the Chief Operating Officer at Wayspring.