Highmark Health’s Multipronged War On Opioids Demonstrates Results

“So many people across the country, and particularly in the regions that we serve, have been affected in some way by the opioid crisis,” said Deborah Rice-Johnson, president, Highmark Inc., at a press briefing on April 16, 2019.  “In response, we launched a ‘war on opioids’ in 2018 to address this urgent problem through new programs, policy changes and partnerships that span across the Highmark enterprise and extend into the community. We are pleased with the initiative’s early progress. But we recognize that this war will not be won easily, and that doing so will require a spirit of collaboration. We are committed to serving our members and the community throughout this evolving public health crisis — including through expanded education and outreach initiatives that combat stigma and re-frame opioid dependence as a chronic disease, rather than a moral failing.”

Highmark’s core health insurance markets have been hit especially hard by the opioid epidemic. Delaware has the nation’s third-highest rate of diagnosed opioid use disorder among patients who are insured by members of the Blue Cross Blue Shield Association (BCBSA), while West Virginia ranks fourth and Pennsylvania ranks 15th. The prevalence of opioid use disorder among Highmark’s commercially insured members as of January 2019 is about seven per 1,000 people.

Highmark has implemented a three-pronged, progressively intensive strategy to address the opioid crisis. The first component focuses on prevention by offering effective, non-pharmaceutical pain management therapies at the site of care. This ensures that members who can manage their pain without opioids never receive them in the first place. Physical therapy, occupational therapy and chiropractic services are covered for Highmark’s fully-insured members, and more than 40,000 practitioners offer discounts to members on alternative treatments such as massages, yoga, acupuncture and homeopathy. Highmark also provides cognitive behavioral therapy through psychologists as adjunctive therapy for pain.

The second component of Highmark’s strategy emphasizes safe opioid utilization through new evidence-based medication policies, as well as ongoing monitoring and educational efforts for both members and prescribers.

In March of 2018, Highmark implemented a new policy for its commercial members who are prescribed opioid-based medications for the first time. The policy, which is designed to enhance safety, limits members in Highmark’s core health insurance markets to a seven-day supply of medication. The policy follows the CDC’s safe prescribing guidelines, which recognize the increased risk of dependence for individuals who use opioid-based medications for an extended period of time.

In addition to the new prescription policy, Highmark uses a data-driven approach to monitor members’ prescription patterns and identify potentially unsafe use of opioids and other controlled substances.

“Our focus on primary prevention and safe opioid prescribing empowers patients and providers to have meaningful conversations about pain management,” said Dr. Charles DeShazer, SVP, Chief Medical Officer, Highmark Inc. “Our goal is for members to partner with providers to identify the most effective, lowest-risk treatment methods that fit their particular pain management needs.”

The third component of Highmark’s strategy focuses on linking our members, your patients who have opioid use disorder with high-quality, accessible treatment programs that mitigate short-term risk and promote long-term recovery.

Watch for more information, coming soon.

Sources: Blue Cross Blue Shield Association July 2018 Health of America report; Highmark Opioids Steering Committee Report