Innovative providers, collaborations and payment strategies credited for increase.
LAS VEGAS–(BUSINESS WIRE)–#Addiction–Anthem Blue Cross and Blue Shield Nevada more than the doubled the number of health plan members receiving whole-person therapies, which are believed to produce better outcomes for opioid use disorder.
To increase positive member health outcomes and lessen the impact of the opioid epidemic, Anthem pledged four years ago to significantly increase the number of members receiving both drug therapy and counseling treatment to treat both mind and body. Anthem met this goal by successfully boosting the combined percentage of employer-based, individual and Medicaid health plan members with opioid use disorder who were receiving both therapies. The increase was from 7 to 39 percent. Medicaid plans alone saw a utilization increase from 6 to 42 percent.
Achievement of this goal aligns with the nation’s commemoration of National Recovery Month, which recognizes people who are in recovery and those who support them. Increasing the number of health plan members receiving both therapies becomes even more relevant as Nevada and the rest of the country struggle 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, amid the pandemic, compared to the same time last year.
“A holistic treatment strategy involving medications, counseling, and lifestyle changes is essential for long term recovery from opioid use disorder,” said Rob Driscoll, Managing Director of Well Care Services Behavioral and Medical Clinic in Las Vegas. “The medications provide biologic stability while counseling and lifestyle changes address the psychological and social aspects of the disease. We are glad to support Anthem in its goal to increase access to this high-quality approach for its members.”
Four years ago, Anthem research of pharmacy and medical claims found that only 7 percent of its health plan members who were taking buprenorphine or naltrexone were also getting the clinically appropriate counseling to successfully change behavior and assist in recovery from addiction. Anthem then committed to work intensely with care providers and others to implement programs to close the gap and encourage counseling as part of all medication assisted treatment, or MAT, services.
The American Society of Addiction Medicine, and the Substance Abuse and Mental Health Services Administration both advocate the use of counseling in combination with drug therapy to treat people with substance use disorder.
“Through our research, we determined that 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 level, and innovative approaches to recovery, including comprehensive, home-based treatment,” said Dr. Dheeraj Raina, Addictionologist and Anthem Medical Director.
To improve the use of counseling with drug therapy, Anthem health plans:
- Promote access to MAT programs as needed, including access to programs offered by Well Care Mental Health Services in Nevada. Access to Well Care programs alone has increase MAT utilization among Anthem’s Medicaid health plan members by 12 percent. Also, Well Care has increased MAT program utilization post-COVID by another 5 percent by implementing access to telehealth and teletherapy.
- Monitor non-fatal overdose metrics to assess real-world impact of holistic strategies, including provider and consumer-based interventions.
- 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, Anthem health plans increased use of these codes by eight times.
Anthem is also committed to supporting holistic policy changes that help reduce, prevent and deter opioid use disorder, as well as policy that helps consumers gain better access to opioid use disorder treatment. Anthem health plans, working in tandem with pharmacy partners, have already been successful in lowering the number of opioid prescriptions filled by Anthem members by more than 53 percent since 2015, when prescriptions peaked.
“Opioid use disorder is a complex societal issue that will take focus and persistence to resolve,” said Dr. William Mack, Anthem Blue Cross and Blue Shield Nevada Medicaid Behavioral Health Medical Director. “By breaking down silos and fostering greater collaboration with our care providers as well as with national patient and industry organizations, we are confident that we can collaboratively find solutions to help ensure our communities have access to the best evidenced-based care for substance use disorder.”
About Anthem Blue Cross and Blue Shield Nevada
Anthem Blue Cross and Blue Shield Nevada helps improve health care access and quality for more than 600,000 Nevadans by developing innovative care management programs and services. Anthem’s top priority is the health and well-being of its members and enabling access to comprehensive health care. Through health education and community outreach programs, members are empowered to choose and sustain a healthy lifestyle. Anthem Blue Cross and Blue Shield is the trade name of Community Care health Plan of Nevada, Inc., an independent licensee of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. To learn more, visit www.anthem.com. Also, follow us on Twitter at www.twitter.com/anthemBCBS_news or on Facebook at https://www.facebook.com/AnthemMedicaid/.
Denise Malecki, Public Relations Director, Anthem