Why Highmark is focusing on stigma in its efforts to address the opioid epidemic 

Highmark Health is taking on stigma as part of its efforts to address the opioid epidemic. (Randy Tarr Photography/Shutterstock)

Pittsburgh-based Highmark Health is focusing much of its work to address the opioid epidemic around one key idea: reducing stigma. 

The insurer recently partnered with Shatterproof, a national group aimed at combating addiction, to offer its employer clients a slate of virtual education tools on the stigma associated with opioid use disorder. Highmark offers plans in Pennsylvania, Delaware and West Virginia.

Through the platform, employees with Highmark insurance can access five-minute modules that explore a variety of topics related to the opioid crisis, including risk factors, symptoms of addiction, treatment options and success stories from people who are recovering from opioid addiction. 


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The modules are designed to be easy to understand and provide an array of supplementary materials for people who want to learn more, including fact sheets and videos. 

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Caesar DeLeo, M.D., vice president and executive medical director of strategic initiatives for Highmark, told Fierce Healthcare that education initiatives like this are critical in combating stigma. 

“It has everything to do with stigma,” DeLeo said. “This will start a revolution that will help break down the barriers of stigma right in the workplace and that will continue to flow through to homes and communities.” 

The partnership was born out of a 2019 community survey conducted by Highmark to gauge attitudes toward opioid addiction in the insurer's core markets. Many of those surveyed (80%) said that opioid dependence is either mostly or somewhat the fault of the addict. 

In addition, in each of the three markets, between 30% and 49% of survey respondents said they would be uncomfortable to learn that a co-worker had an opioid addiction. 

However, despite the majority holding that view, more than three-quarters of the survey respondents said they believe they should encourage friends or family members to seek treatment if they need it. DeLeo said that highlights the impact of stigma: It prevents diagnoses. 

RELATED: An insurer built an algorithm to help employers track opioid use. Now, they’re giving away the data for free 

Highmark’s core markets have also been hit hard by the opioid crisis—the survey found that, across the three states, between 34% and 57% of people said a family member or close friend had suffered from opioid addiction. 

The efforts to combat stigma are just one prong of the insurers’ multifaceted approach to mitigating the opioid crisis. Highmark also provides coverage for non-pharmacological pain treatments, arms providers with evidence-based medication guidelines when opioids are necessary and offers ongoing monitoring for opioid use. 

Highmark also makes naloxone available to prevent fatal overdoses. DeLeo said the insurer has seen notable results in reducing overdoses—opioid overdose rates among Highmark members have declined by 70% and are 50% below the national average. 

Because the insurer’s markets are diverse, including urban areas, suburban areas and heavily rural areas, a major challenge is finding providers who can treat opioid use disorder once it’s been diagnosed, DeLeo said. 

RELATED: Philadelphia fell victim to the opioid epidemic. Its largest insurer is trying to save it 

In West Virginia, for example, members have extremely limited options for medication-assisted and other evidence-based treatment options, so Highmark is filling the gaps using telehealth. Highmark is looking to expand access to telepsychiatry and virtual treatment over the course of 2020, DeLeo said. 

Digital health options like telepsychiatry can address stigma, too, DeLeo said, as it may be a way to get someone who’d be embarrassed to go to a therapist in person into treatment. 

“Maybe people don’t want to go and be seen being treated but would be quite comfortable talking on the phone or by Skype,” he said. “We’re very flexible. We’re not intending to be competitors—we want to be complementary and fill in the gaps.”