Insurers partner with providers to curb opioid abuse

Health insurers are making strides to address opioid addiction by partnering with providers and providing a clearer picture of patients' medical history through claims data, according to Hospitals & Health Networks Magazine.

Hospital leaders have already begun searching for ways to stem the rise of opioid abuse, and President Barack Obama has allocated $559 million in his 2017 proposed budget to fight opioid addiction. And insurers also are rolling out initiatives that inform physicians of possible addiction concerns.

The Association for Community-Affiliated Plans (ACAP), which oversees 60 safety-net plans, has taken a leading role in this effort, according to HHN. Last year, ACAP convened a handful of members and identified ways to reduce the rising costs of opioid prescribing by locking patients into one pharmacy provider--known as "lock-in" programs--and alerting primary care providers when patients visit another emergency department (ED).

For example, Texas Children's Health Plan recently saw a spike in teens admitted to the ED for opioid poisoning. A claims analysis showed many adolescent beneficiaries were getting opioids from dentists or orthopedists. Since then, the plan has trained primary care physicians to screen teens for signs of opioid abuse. Meanwhile, a Wisconsin provider-owned health plan has begun "discreetly" reaching out pregnant women with signs of addication and their providers to discuss weaning their babies off of opioids once they are born.

Although insurers often fall short when it comes to substance abuse treatment, some payers have made efforts to address opioid addiction, including one Massachusetts insurer that assigned social workers to provide follow-up support following addiction treatment. Blue Cross Blue Shield of Massachusetts also contacts members in detox programs to coordinate care once they are discharged.

To learn more:
- read the HHN article

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