Anthem Affiliated Health Plans More Than Doubled the Number of Consumers Receiving Whole-Person Treatment for Opioid Use Diso...
September 02 2020 - 11:13AM
Business Wire
Innovative providers, collaborations and
payment strategies lead to increase
To make a positive impact on consumer health and lessen the
impact of the opioid epidemic, Anthem affiliated health plans
pledged four years ago to ensure significantly more consumers
received both drug therapy and counseling treatment in an effort to
treat the whole person and achieve what are believed to be better
outcomes for opioid use disorder.
Anthem met these goals by boosting the combined percentage of
consumers in employer-based, individual and Medicaid plans with
opioid use disorder receiving both therapies from 18 percent to 36
percent in 26 plans nationally—more than doubling the number of
consumers receiving both therapies. Medicaid plans alone increased
from 24 percent to 55 percent.
The goal was met just as the country commemorates National
Recovery Month, which recognizes people who are in recovery and
those who support them. Increasing the number of consumers
receiving both therapies becomes even more relevant as the country
struggles with the COVID-19 pandemic. The White House Drug Policy
issued a recent analysis showing that drug overdose deaths are up
11 percent for the first four months of 2020 during the pandemic
compared to the same time last year.
“It’s more important than ever that health insurers, like
Anthem, are taking a leadership role and helping to ensure people
receive comprehensive treatment for opioid and other substance use
disorders,” said Greg Williams, a national recovery advocate
instrumental in the launch of the seminal Surgeon General’s report
on Alcohol, Drugs, and Health: Facing Addiction in America, and
co-founder of The Alliance for Addiction Payment reform.
“Medication for certain substance use disorders has the potential
to save lives, but medication alone is not a panacea for long-term
outcomes. The best way to promote sustained recovery is to combine
the use of medication in treatment with evidence-based behavioral
therapies and recovery support services.”
Anthem is committed to supporting holistic policy changes that
help reduce, prevent and deter opioid use disorder, as well as
those that help consumers gain better access to opioid use disorder
treatment and assist in their recovery. Its health plans, working
in tandem with pharmacy, have already been successful in lowering
the number of opioid prescriptions filled by more than 60 percent
since 2015 when prescriptions peaked.
“Opioid use disorder is a complex societal issue that will take
focus and persistence to resolve,” said Dr. Charles Gross, vice
president, Anthem behavioral health. “By breaking down silos and
fostering greater collaboration with our care providers and other
national patient and industry organizations, we are confident that
together we can find solutions to help ensure our consumers have
access to the best evidenced-based care for substance use
disorder.”
Four years ago, Anthem’s research of pharmacy and medical claims
found that only 18 percent of consumers taking buprenorphine or
naltrexone were also getting the clinically appropriate counseling
to successfully change behavior and assist in recovery from
addiction. Anthem health plans then committed to work intensely
with care providers and others to implement programs to close the
gap and encourage counseling as part of all medication-assisted
treatment, or MAT, services.
The American Society of Addiction Medicine and Substance Abuse
and Mental Health Services Administration both advocate the use of
counseling in combination with drug therapy to treat people with
substance use disorder.
“Through our research, we determined there were key barriers to
consumers getting the therapy they need – availability of local
care providers participating in MAT, appropriate screenings at the
primary care provider, and innovative approaches to recovery,
including comprehensive, home-based treatment,” said Dr. Dheeraj
Raina, addictionologist and Anthem medical director.
To improve the use of counseling with drug therapy, Anthem
health plans:
- Provide access to telehealth MAT programs in several markets to
ensure convenient options and have committed to growing this access
post-pandemic. About 19-25 percent of those receiving MAT began to
receive their counseling via telehealth, compared with about 1
percent before the pandemic.
- Monitor non-fatal overdose metrics to assess real-world impact
of holistic strategies, including provider and consumer-based
interventions.
- Developed a program using predictive analytics to determine
which members are most at risk of negative health outcomes from
opioid or alcohol abuse. This program, which includes outreach to
members, will expand to 17 cities in 2020.
- Encourage primary care providers to become certified in MAT by
standardizing reimbursement for these services between primary care
and behavioral health providers.
- Developed bundled payments with practices that encourage
treatment for both drug therapy and counseling.
- Make primary care practices aware of how to bill for early
identification and screening for opioid addiction through actively
encouraging the use of Screening, Brief Intervention and Referral
to Treatment, or SBIRT, codes. Since 2016, Anthem health plans
increased use of these codes by 12 times.
- Support innovative programs, such as Aware Recovery Health, in
Connecticut, Maine and New Hampshire, to study and research models
that take an in-home treatment approach to recovery.
- Support improving the MAT skills of primary care providers by
providing access to substance abuse experts via Project ECHO in
West Virginia, South Carolina and other states hardest hit by the
opioid epidemic – and via provider contracts with Clean Slate and
Groups Recover Together in California, Kentucky, Indiana, New
Hampshire, Maine, Wisconsin and Virginia. Anthem providers
nationwide can collaborate with the main Project ECHO center in New
Mexico.
About Anthem, Inc.
Anthem is a leading health benefits company dedicated to
improving lives and communities, and making healthcare simpler.
Through its affiliated companies, Anthem serves more than 106
million people, including more than 42 million within its family of
health plans. We aim to be the most innovative, valuable and
inclusive partner. For more information, please visit
www.antheminc.com or follow @AnthemInc on Twitter.
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version on businesswire.com: https://www.businesswire.com/news/home/20200902005740/en/
Lori McLaughlin Cell 317.407.7403
Lori.mclaughlin2@anthem.com
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