Health Plans Work To Find Solutions To The Opioid Crisis

by Dr. Richard Bankowitz

October 31, 2017

This Nation is currently confronting a devastating and urgent health crisis.  In recognition of the magnitude of the problem, President Donald Trump declared the opioid epidemic a Public Health Emergency.  America’s health insurance providers have been on the front lines of this emergency for some time and have seen firsthand the harm and disruption it has caused to their customers, their families and their communities.

For several years, health plans have been partnering with federal and state leaders, doctors, hospitals and community organizations to find effective non-opioid and non-pharmacologic treatment options for chronic pain, and to ensure patients struggling with addiction get the evidence-based treatment and support they need.

Health plans across the country are implementing solutions that work.  Here are but a few examples:

  • After seeing that people were getting prescriptions for 1,000 opioid pills at a time, Kaiser Permanente doctors in Southern California changed how their colleagues thought about and treated pain. Inappropriate prescribing of opioids has dropped by 30 percent as a result of their efforts.
  • UPMC Health Plans begins with childhood prevention and extends through a lifetime of interventions and treatment – its comprehensive approach has led to continuous year-over-year reductions in the prescribing and use of opioids.
  • As Cigna delivers on its pledge to reduce opioid use among its customers by 25 percent by 2019, next year the plan will no longer cover most OxyContin prescriptions and will instead guide patients to a covered abuse-deterrent equivalent.
  • In another show of commitment and success, Anthem reached its goal of reducing prescribed opioids dispensed at pharmacies by 30 percent two years earlier than expected.
  • Independence Blue Cross has developed a number of initiatives to prevent and fight opioid addiction, such as restricting initial prescriptions of low-dose opioids to five days or less and working closely with physicians on prescribing. In 2017, the number of their members taking opioids fell by 20 percent and the number of opioid prescriptions has fallen by more than a third.
  • Centene, Harvard Pilgrim and AmeriHealth Caritas, among others, are also pursuing avenues of non-pharmacologic pain management and offering coverage for therapies such as acupuncture when determined medically necessary.
  • American Specialty Health (ASH), which works with more than 130 health plans across the United States, makes evidence-based therapies for pain management easily accessible to patients through one platform, or “eco-system,” that guides patients to the right help.

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These examples show the great progress health plans have made in reducing the number of addictive substances in our communities.  But we agree; more can – and should – be done. That’s why our teams are implementing programs that work and are finding new solutions.  For example, AHIP launched the STOP Initiative to ensure Safe, Transparent Opioid Prescribing for pain care.  Our first action under this initiative is the release of the STOP Measure, an evidence-based methodology developed from the work of AHIP’s Opioid Workgroup, that health plans can use to measure how well providers are following the CDC guidelines for safe opioid prescribing.

This is just the start.  We won’t give up fighting for an end to the epidemic, and we will remain focused of reducing opioid dependency and improving the lives of our communities.

For more information about health plan efforts to address the opioid crisis, please visit: https://www.ahip.org/issues/opioids/

Dr. Richard Bankowitz, MBA, FACP, is Chief Medical Officer of AHIP.