In the News: Payers Partner with Providers to Fight Opioid Epidemic

Monday, May 22, 2017

According to a recent Centers for Disease Control (CDC) report, 63% of accidental deaths in the U.S. are attributed to some form of opioid use or misuse. Mounting concern over the national crisis of opioid abuse and overutilization is reaching every corner of the healthcare landscape. The payer take on the epidemic is discussed in “Payers, Providers Collaborate to Combat Opioid Abuse, Addiction,” a recent article on the HealthPayer Intelligence site.

Many payers see their contribution to the fight in the potential to reduce the number of unnecessary and diverted prescriptions for opioid painkillers. That requires partnership with prescribers and healthcare providers.

Payers interviewed for the article state ambitious goals of reducing members’ opioid prescriptions by, in some cases, up to 30% in the next two years. Methods for achieving this include:

  • Alerting prescribers to members who have exceeded recommended levels of use
  • Reducing pharmacy benefit coverage for members who have been flagged for unsafe use
  • Requiring affiliated providers to adhere to actions outlined in an opioid epidemic awareness pledge, including performance measurement
  • Reforming prior authorization policies for addiction treatment
  • Lobbying for government rule changes that eliminate or reduce prescriber performance measures that encourage prescribing frequency or volume

Some payers claim they are already seeing positive results from such programs and efforts.

Read the full HealthPayer Intelligence article.

Want to learn more about related topics? Check out these RxPerts Academy features on the opioid epidemic:

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