Leaders from the Healthy State Alliance say fragmented care transitions and workforce shortages continue to challenge Ohio’s opioid response, even as health systems work to expand medication treatment and improve coordination.
Although Ohio has made progress addressing the opioid crisis, leaders from an alliance of healthcare providers say the state’s addiction-response landscape still suffers from fragmentation that can leave patients without consistent support.
“Ohio has made progress in reducing inappropriate prescribing and expanding treatment, but care is still too fragmented,” said leaders from the Healthy Alliance, a strategic partnership between The Ohio State University Wexner Medical Center and Bon Secours Mercy Health. “Patients often move from emergency departments to outpatient treatment to recovery services without clear coordination between systems.”
The Healthy State Alliance was created to combine the strengths of a leading academic medical center with a large community-based health system in order to tackle some of the most pressing health challenges facing communities across Ohio. By working together, the organizations aim to improve health outcomes while also making care more accessible and affordable for the populations they serve.
Through the alliance, the two health systems coordinate clinical care, research, education and community health initiatives across a broad network of providers and care sites. Their work focuses on major health priorities such as addiction, cancer care, transplant services and broader community health needs. By sharing resources, expertise and clinical best practices, the alliance seeks to expand access to specialized care, support innovation in treatment and research, and address underlying factors that influence health outcomes in communities throughout the state.
Two leaders spoke to Repertoire Magazine regarding the alliance’s mission, challenges, and goals:
- Trent Hall, DO, a board-certified Addiction Medicine specialist and assistant professor at The Ohio State University Medical Center. He researches addiction mechanisms, chronic pain, and overdose deaths while leading the East Hospital Addiction Medicine Consult Services.
- W. Carson Felkel, MD, a board-certified Psychiatrist and Systems Medical Director for Behavioral Health at Bon Secours Mercy Health.
Drs. Hall and Felkel serve as co-leads for the Healthy State Alliance Addiction initiative, where they have achieved success in leading a cross-functional team in developing opioid-sparing protocols, implementing strategies for prescribing medication for opioid use disorder across medical systems, and delivering educational content to address stigma in healthcare providers. Drs. Hall and Felkel serve as investigators in several addiction and pain related research studies across Bon Secours Mercy Health and Ohio State.
Viewing addiction as a chronic condition
According to Drs. Hall and Felkel, health systems and community organizations frequently work toward the same goals but operate separately rather than together. That disconnect can make it harder for patients to stay engaged in care as they transition between treatment settings.
To address those gaps, the Alliance is working to create a more connected system of care by standardizing evidence-based practices and strengthening coordination among providers, payers and community partners.
“The Alliance aims to close those gaps,” they said. “We focus on standardizing evidence-based practices such as medication treatment for opioid use disorder, improving care transitions, and aligning health systems, payers and community partners around shared outcomes.”
The Alliance’s strategy reflects a broader shift toward viewing addiction as a chronic condition that requires long-term support across prevention, treatment and recovery.
“We view addiction as a chronic condition, so prevention, treatment and recovery have to move forward together – not in stages,” the Alliance leaders said.
Collaboration is central to the effort. The Alliance brings together clinicians, executive leaders, community members and policymakers to develop initiatives that can be implemented across the state.
Policy changes have also helped expand access to care. Leaders say expanded telehealth access for medications used to treat opioid use disorder has been particularly impactful in rural communities, while reducing administrative barriers and strengthening integrated behavioral health care continue to improve access across the state.
Policy and practice
Even as policymakers continue to push for expanded addiction treatment, leaders with the Healthy State Alliance say the realities facing healthcare providers often make implementation difficult.
“Policy expectations often move faster than operational capacity,” the Alliance leaders said. “Providers are encouraged to expand medication treatment and integrate behavioral health, but they still face workforce shortages, inconsistent support structures, and limited time for training.”
Those operational challenges remain among the biggest obstacles to expanding addiction care across Ohio. Workforce shortages – particularly among addiction-trained clinicians and behavioral health specialists – continue to strain hospitals and outpatient providers. At the same time, inconsistent reimbursement and administrative burdens can slow progress toward broader treatment access.
Hospitals and clinicians also play a much larger role in addiction care than simply responding to overdoses. Alliance leaders emphasize that health systems can serve as critical gateways into long-term treatment and recovery.
“Hospitals are more than emergency responders – they are key entry points into long-term treatment and recovery,” Drs. Hall and Felkel said. “Health systems can initiate medication treatment, improve pain management practices, screen for substance use disorder in routine care, and ensure warm handoffs to outpatient and community services.”
Clinicians themselves also help shape the culture of care. By treating addiction as a routine medical condition rather than a stigmatized disorder, providers can help normalize treatment and encourage more patients to seek help.
The Alliance measures success not simply by individual programs but by broader system change. “We look at expanded access to medication treatment, adoption of standardized clinical protocols, and stronger coordination between hospitals and community partners,” the leaders said. “For us, success means sustained system change – not just short-term program activity.”
Priorities and goals
Improving access across Ohio – especially in rural and underserved areas – remains a central priority of the Healthy State Alliance. Telehealth, regional partnerships and shared clinical protocols help extend specialty expertise to communities that may lack addiction specialists.
Community-based organizations have also shaped the Alliance’s approach. Their work highlights the importance of trust and long-term support in recovery. Peer recovery specialists – individuals who have experienced recovery themselves – often help patients stay engaged in treatment.
Looking ahead, Alliance leaders say their goal is to create a fully connected addiction care continuum where prevention, treatment and recovery are seamlessly linked, and where access to care no longer depends on geography.