We continue the discussion on opioid abuse in America, following up on our post, Leveraging Advanced Analytics to Address Opioid Abuse.

Over the past twenty-five years, the United States has become the leading consumer of opioid pain medications, with the rate of prescriptions skyrocketing since 1991. In 2012 alone, 259 million prescriptions were written for opioids – enough to give every American adult his or her own bottle of pills.

opioid chart
Opioid Prescriptions Dispensed by US Retail Pharmacies, 1991 – 2013

For insurers, understanding the people, demographics, risks, and cost-drivers is an essential step towards addressing the problem. As Dr. Richard Snyder, Senior Vice President and Chief Medical Officer of Independence Blue Cross, noted in a recent interview: health plans can play a vital role in reducing opioid addiction – starting with prevention. For their part, Independence Blue Cross has multiple programs in place to limit opioid prescribing, better understand “doctor shopping” behaviors, and provide education on alternative pain therapies.

As opioid mitigation programs gain prominence, how can health plans enact preventative measures, conserve resources, and still support members coping with opioid abuse?

“There’s no doubt insurers can play an integral role in addiction prevention and recovery.”

-Dr. Richard Snyder, SVP and Chief Medical Officer, Independence Blue Cross

At NextHealth, we have identified three ways for health plans to get ahead of the opioid crisis.

1. TARGET: More accurately predict which members are at risk for opioid abuse, based on key attributes such as chronic pain management behaviors.

  • Health plans can use this knowledge in conjunction with the predictive and prescriptive capabilities of the NextHealth platform to impact member behavior and drive at-risk members to alternatives. By understanding the key behaviors of members and how best to interact with members with opioid disorders, health plans can enhance the role they play in combating this public health epidemic.

2. MEASURE:  Track and evaluate program effectiveness to help divert members to other pain management options, such as non-opioid painkillers, physical therapy, and other treatments.

  • By evaluating current programs and working to divert members to alternative options, health plans can help reduce the number of members who develop an opioid use or abuse disorder.
  • Health plans can finally understand what programs are working – and which aren’t – so resources can be strategically allocated to have the greatest impact.

3. OPTIMIZE: Refine and tailor programs, channels and messages to engage with specific populations to best impact their behavior.

  • The NextHealth platform helps plans understand which messages resonate with specific member populations, tailoring outreach to key segments.
  • Health plans can optimize programs to focus only on the most impactful messages and channels, and pivot quickly.
  • For members already dealing with addiction, our platform measures and optimizes assistance programs to provide the best resources towards recovery.

Given the scale of the problem and the associated budgetary demands, it’s more important than ever that insurers know which interventions provide the greatest benefit, so they can get the most out of every engagement dollar spent. Opioid misuse is causing increased emergency room utilization, inpatient stays and most tragically of all, overdoses. Many of these problems can be prevented, provided that opioid disorders are recognized and supported by appropriate interventions. At NextHealth, we are supporting insurers, engaging with members, and helping all of us understand how to get ahead of the opioid crisis.

By Lindsey Miller, Engagement Manager, NextHealth Technologies

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