Anthem Affiliated Health Plans More Than Doubled the Number of Consumers Receiving Whole-Person Treatment for Opioid Use Disorder
Innovative providers, collaborations and payment strategies lead to increase
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
“Opioid use disorder is a complex societal issue that will take focus and persistence to resolve,” said Dr.
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.
“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.
To improve the use of counseling with drug therapy,
- 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,
Anthemhealth plans increased use of these codes by 12 times.
Support innovative programs, such as
Aware Recovery Health, in Connecticut, Maineand 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 Carolinaand 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, Wisconsinand Virginia. Anthemproviders nationwide can collaborate with the main Project ECHO center in New Mexico.