Ophelia Adds Two Healthcare Experts to Board for Payor Growth

Ophelia, a next-generation provider of opioid addiction treatment, has made significant advancements with the recent appointment of Marc Russo and Trip Hofer to its board. The inclusion of these seasoned professionals aims to bolster Ophelia’s mission of expanding its commercial payer and Medicaid business, thereby promoting broader access to essential treatments.

Ophelia specializes in a virtual-first care model designed to enhance accessibility and retention in evidence-based treatments for opioid use disorder (OUD). This model is particularly focused on assisting rural, underserved, and historically stigmatized patient demographics. The company collaborates with 27 health insurance plans, encompassing Medicaid, Medicare, and various commercial lines. Approximately 70% of Ophelia's patient base consists of individuals covered by Medicaid, reflecting the acute need within this population.

In a recent study published in Health Affairs Scholar, Ophelia revealed that patients utilizing in-network insurance benefits demonstrated six-month retention rates that were 50% higher compared to those paying out-of-pocket. This finding underscores the crucial role of insurance coverage in not only facilitating access to treatment but also in ensuring long-term positive outcomes, including enhanced survival rates and quality of life.

Marc Russo brings over a quarter-century of leadership experience in the payer sector to Ophelia. His expertise is particularly profound in Medicaid, having served as the EVP and President of Medicaid Plans at Molina. At Molina, he oversaw the coverage of 5.2 million lives across 19 states. Russo's career also includes significant roles at Anthem, WellCare Health Plans, Blue Shield California, UnitedHealthcare, and Oxford Health Plans.

Russo commented on his new role, stating, "The opioid epidemic remains one of our nation’s most pressing challenges due to the lack of access to effective treatments. I am impressed by Ophelia’s innovative approach to expanding access through direct-to-patient strategies, particularly within Medicaid. I am honored to join Ophelia’s board and contribute to expanding access to this vital treatment for those in need."

Trip Hofer, another esteemed addition to Ophelia’s board, brings over 25 years of experience in health technology and executive leadership. Hofer was previously the CEO of AbleTo, a virtual behavioral health company that scaled significantly before being acquired by Optum. He then became CEO of Optum Behavioral Health. Presently, Hofer serves as the CEO of Redox, a company focused on facilitating seamless healthcare data exchange through reusable technology. He is also a Venture Partner at .406 Ventures and sits on the boards of Heartbeat Health and Brightside Health.

Hofer expressed his enthusiasm, saying, "Ophelia has developed a top-tier care delivery program that is user-friendly for both patients and providers and is poised for large-scale impact. The leadership team’s blend of ethics, thoughtfulness, and expertise positions Ophelia for continued success. I am excited to aid in strengthening Ophelia’s strategic partnerships with payors and providers to align all stakeholders toward our shared goals."

Zack Gray, the founder and CEO of Ophelia, emphasized the importance of affordability and accessibility in opioid addiction treatment. He stated, "Ophelia aims to make evidence-based care easy to opt into and persist with, and affordability is key to this. Our partnerships with progressive payors enable us to achieve this. We are thrilled to have Trip and Marc contribute their experience and expertise to our mission."

Ophelia’s expansion is timely, as the company experienced a 40% growth in the first quarter of 2024. Over the past year, Ophelia has joined eight new health plan networks on value-based contracts and was designated as an OUD Center of Excellence by the state of Pennsylvania, enhancing access to Medicaid beneficiaries statewide.

Ophelia is committed to making medication-assisted treatment for OUD universally accessible, focusing on removing barriers for the 80% of Americans who currently lack access to care. Utilizing the Ophelia Care Model, a clinical and technology platform, the company is licensed to operate in over 30 states and accepts Medicaid, Medicare, and commercial insurance.