One of the greatest current public health challenges is the explosion of opioid abuse disorders. Based on 2015 data, the Centers for Disease Control and Prevention has determined that more than 33,000 people die annually due to opioid abuse (including prescription opioids and heroin). Additionally, opioid abuse has been tied to the recent report indicating life expectancy declined in the US in 2015.

The Blue Cross Blue Shield Association’s Blue Health Index recently examined opioid use disorder among the commercially insured population (under 65). BCBSA, in conjunction with Blue Health Intelligence and Axial Healthcare, reviewed claims data to determine that substance use disorders were the fifth most impactful health condition affecting the US commercially insured population.

Many NextHealth clients recognize this epidemic of opioid use and overuse and grapple with two fundamental questions:

  1. How do we predict and understand the members who are driving the utilization?
  2. What can we do to change their behavior?

The NextHealth team has developed new Key Performance Indicators (KPIs) that can predict opioid abuse and use disorders, which increased 493% between 2010 and 2016.

Source: Blue Cross Blue Shield Association (2017)

Meanwhile, the surge in diagnoses has significantly outpaced the availability of treatment and support. The highest concentration of members receiving medication assisted treatment are located in the Northeast, but the highest use of opioids is seen in the South and lower Midwest.


Source: Blue Cross Blue Shield Association (2017)

As health plans race to combat this growing public health issue, they are trying a variety of programs and interventions to get ahead of the people who may become abusers. The NextHealth platform can help by providing real-time analytics and program evaluation on the interventions that are working and those that are not. This real-time program evaluation allows our clients to pivot quickly and focus resources on the interventions that are working. For more information on how the closed-loop process drives outcomes, see “How it Works“.

Additional sources:

  1. CDC. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at
  2. Substance Abuse and Mental Health Services Administration. Highlights of the 2011 Drug Abuse Warning Network (DAWN) findings on drug-related emergency department visits. The DAWN Report. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; 2013. Available from URL:

Contributed by Lindsey Miller, Engagement Manager, NextHealth Technologies

NextHealth’s platform quickly scales to multiple use cases.