News & Commentary

Health Plan Efforts to Address the Opioid Epidemic: A National Emergency

September 19, 2017
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Every day, 91 Americans die of an opioid overdose. The total number of opioid-caused deaths has quadrupled in the past 20 years[1]. Every 25 minutes, an infant is born experiencing opioid withdrawals[2]. The United States is in the middle of a crisis, and policymakers, providers and health insurance companies are all invested in helping change our course. 

Last week, the Association for Behavioral Health and Wellness (ABHW) held an event that explored current efforts underway by U.S. health plans to confront the opioid epidemic. The event featured panelists from three different health plans, including Anthem’s Vice President of Behavioral Health & Clinical Programs, Dr. Sherry Dubester. Panelists were invited to share various programs and strategies their companies are employing to stem the tide of this crisis.

A number of key insights arose during this conversation about how this epidemic might be stopped and the role that health plans can play. 

Effective treatment is flexible and addresses the whole person

Panelists were in agreement that the best approaches to combating the opioid epidemic are those that can be tailored to the individual patient’s needs. Because opioid addiction does not affect each person the same way, treatment plans must be designed to flex. The panelists encouraged treatment design by way of evidence-based, individual treatment plans, which integrate a variety of tools. The plans can include, but aren’t limited to:

  • Medication-assisted therapy
  • Psychotherapy
  • Family therapy
  • Primary care providers
  • Pharmacy lock ins (for high-risk patients)
  • Community sobriety tools (AA, Lifespan)

In addition to a flexible, evidence-based plan, it follows that any effective treatment plan should include tools to address the physical health of the person as well as their emotional and psychological wellbeing. Turbulence in a person’s emotional wellbeing is as likely to cause relapse as any physical withdrawal symptoms, so any treatment plan must address both the physical and emotional toll of the disease.

Panelists agreed that an effective treatment plan must also emphasize patient engagement. Health plans, for instance, are addressing the issue of isolation for those with opioid use disorders, which can be devastating to sobriety efforts.

Effective solutions to the epidemic include measures for prevention, treatment and deterrence

Dr. Dubester suggested that three core strategies are important to address the opioid epidemic:  prevention, treatment and deterrence. If any one of these elements is prioritized too highly, the others will become imbalanced. A key element of the prevention-focused strategy is a health plan’s ability to identify risk early on. By appropriately using member data, plans can identify those who suffer from chronic pain, acute pain and other identifiers that point to a risk case for opioid addiction.

Additionally, health plans that focus on increasing access to evidence-based treatments have a stronger chance of success, as do plans that use pharmacy home programs as a deterrent. Pharmacy home programs require high-risk populations to go to only a single pharmacy to receive their medication to cut down on the temptation to misuse opioids.

Improving access to care improves outcomes

Effective treatment requires improvements in access to care. The opioid epidemic is at its worst in rural parts of America because those areas may lack access to treatment.

Through modern innovations like telemedicine, treatment plans can be devised that provide low-cost, effective intervention. Through telemedicine, a patient can have nearly unfettered access to his or her care providers, who are all critical in devising the best plan to treat the whole patient. With the click of button, a patient can be connected with his or her primary care physician, mental health professional and addiction medicine specialists.

During this panel, two larger themes were made clear. First, the opioid epidemic is a complicated, multi-faceted problem that will require a shift in thinking among providers, patients and payer organizations to achieve an integrated solution. The second is that the health care community is committed to these solutions and to improving outcomes for patients.


Read more about Anthem’s efforts to combat the opioid epidemic.

Learn about ABHW’s work on the opioid epidemic.




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