Health insurers are not sitting back and letting the opioid epidemic put a dent in their efforts to increase care quality and cut healthcare costs. Instead, they have designed holistic approaches to treating members who are abusing or overusing these sometimes-dangerous painkillers.
A July 2015 study in Mayo Clinic Proceedings found one in four people who were prescribed a narcotic painkiller for the first time progressed to long-term prescriptions, putting them at risk for dependence and dangerous side effects.
There is some good news, however: IMS Health reports that U.S. opioid use has declined for the first time in 20 years, 12% fewer prescriptions nationally since a peak in 2012.
One of the primary causes of opioid abuse is patients who are prescribed the drugs for short-term pain relief but receive many more doses than needed, says Mary Jo Carden, vice president, government and pharmacy affairs, Academy of Managed Care Pharmacy.
She puts her money on prescription drug monitoring programs (PDMPs), state-based electronic databases that track the dispensing of controlled substances in a state. They are designed to monitor this information for suspected abuse or diversion and to give providers critical information regarding their patients' controlled prescription drug history.
This year, the CDC developed the "Guideline for Prescribing Opioids for Chronic Pain," which emphasizes using non-opioid therapies for chronic pain, initiating the lowest effective dose for the shortest time period and screening for abuse.
Here are four plans that are going above and beyond new recommended guidelines and requirements to combat opioid abuse and misuse.