Health Plans Provide Leadership To Address The Opioid Crisis

posted by Kate Berry

on March 26, 2019

The number of Americans who suffer from substance use disorders is estimated to be more than 20 million. There’s also been a dramatic increase in prescription drug overdoses—more than 70,237 drug overdose deaths in 2017 alone. Two-thirds of those deaths involved an opioid like morphine, oxycodone, or hydrocodone. Concerns about growing opioid misuse, addiction, and overdoses have led health insurance providers to take a leadership role in combating this public health crisis.

Below are a few examples.

AllWays Health Partners waives out-of-pocket costs for certain opioid alternatives for pain treatment. The Care Complement Program supports patients and doctors in better managing chronic pain with affordable alternatives. Under the program, a patient can receive introductory chiropractor services, acupuncture, pain management therapy, and physical or occupational therapy with no out-of-pocket costs for initial visits.

Blue Cross Blue Shield of Tennessee found 55% of recreational prescription drug users get their pills from a friend or relative. So, it partners with a local nonprofit initiative Count It! Lock It! Drop It! to encourage residents to safely and securely store their medications and to promptly dispose of unused medications at approved drug disposal locations.

Cigna uses a community-based approach to improve access to care and resources for chronic pain and addiction. The approach aims to reduce opioid overdoses by 25% among its consumers by 2021. It plans to meet this goal by using predictive analytics to identify customers who are most at risk of overdose and prompting interventions to prevent it.

Harvard Pilgrim Health Care encourages non-opioid approaches to managing pain when appropriate. For example, Harvard Pilgrim Health Care covers pain treatments such as non-opioid prescription drugs (such as analgesics, NSAIDs, and skeletal muscle relaxants), physical therapy (PT) or occupational therapy, massage therapy as part of a PT regimen, chiropractic care, acupuncture, and other medical interventions.

Magellan Health has taken an innovative approach to address the opioid epidemic with digital cognitive behavioral therapy. The software provides access to care via desktops, tablets, and smartphones so that care goes beyond geographic or scheduling boundaries. The insurance provider also offers the SHADE program, a 10-session mobile- and web-based program for individuals living with substance use disorder and co-morbid depression.

SCAN Health Plan is working to recalibrate how providers prescribe and treat acute and chronic pain. It’s retraining its provider community about opioids and partnering with the American Society of Addiction Medicine (ASAM) to offer tools for having difficult conversations with patients about substance use. SCAN Health Plan also shares prescribing pattern information with medical groups to help them monitor how their prescribing compares to peers.

Government agencies and other stakeholders have also worked to address opioid abuse and addiction. For example:

  • The White House released the National Drug Control Strategy to identify and address the top priorities associated with the opioid crisis.
  • The Centers for Disease Control and Prevention (CDC) released guidance on how to incorporate prescribing guidelines into practice.
  • The Pain Management Inter-Agency Task Force published a report on pain management best practices, identifying gaps and inconsistencies and providing recommendations.
  • The U.S. Surgeon General released an update to its Facing Addition In America report, with a spotlight on opioids.
  • The National Governors Association issued recommendations for federal action to end the nation’s opioid crisis.

Combating opioid misuse, abuse, and addiction requires evidence-based treatments for pain management, more cautious opioid prescribing, careful patient monitoring, and access to substance use disorder treatment and recovery support. While progress is being made, we recommend additional efforts in the following areas:

  • Provide ongoing education and easy-to-follow guidelines for providers and consumers about ways to manage pain without prescription opioids as much as possible.
  • Improve the accuracy, timeliness, ease of use, access, and cross-state sharing of information collected from Prescription Drug Monitoring Programs—state databases tracking controlled substances including opioid prescriptions.
  • Expand the capacity for treating opioid addiction—strengthening the workforce of providers to manage medication-assisted treatment (MAT) and deliver behavioral counseling, as well as increasing the availability of community-based support resources to assist with recovery.
  • Enhance communication and coordination of services between primary care providers, specialists, and mental health practitioners to improve care.

To learn more about the opioid crisis and how health insurance providers are responding, see AHIP’s Safe, Transparent Opioid Prescribing (STOP) Initiative for more information.

Kate Berry is Senior Vice President of Clinical Affairs and Strategic Partnerships at AHIP