With the opioid epidemic being a public health crisis that disproportionately affects poor and disabled Americans, the Association for Community Affiliated Plans (ACAP) has published a report outlining notable practices to combat opioid misuse and overuse of five of its member Safety Net Health Plans.
Overall, the ACAP represents 60 Safety Net Health Plans, which provide health coverage to more than 20 million Americans in 29 states through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), the Health Insurance Marketplace and other programs.
The five plans profiled in the ACAP report and their respective initiatives are:
- Neighborhood Health Plan of Rhode Island – The plan’s Ease the Pain program provides access to alternative pain management treatment, peer outreach and co-managed care rounds to facilitate collaboration between physical and behavioral health providers.
- University of Pittsburgh Medical Center Health Plan – The HEDDS UP program identifies members with an opioid prescription and who have visited an emergency department at least five times within the past six months, notifies their providers of overutilization, and engages members face-to-face to connect them to appropriate resources.
- Inland Empire Health Plan (serving Southern California) – The Behavioral Health Integration and Complex Care Initiative is a partnership across 30 provider sites that targets members with multiple complex conditions (one of which must be behavioral health or substance use) for targeted outreach by a dedicated integrated care team.
- Partnership HealthPlan of California – In Project ECHO, a collaboration with the University of California-Davis, the health plan provides skills training to providers who care for patients with chronic pain.
- Community Health Plan of Washington – The plan has conducted intensive data analysis on integrating pharmacy and medical claims data, as well as the state’s Emergency Department Information Exchange, to identify at-risk members.
ACAP CEO Meg Murray tells Behavioral Healthcare Executive that the diversity in the initiatives covered in the report was by design.
“Substance abuse is a multipronged issue, and so it needs a multipronged solution,” she says.
With uncertainty over the nation’s health insurance landscape looming, and potential changes that could directly impact plans represented by ACAP, Murray says it is critical for Safety Health Net Plans to leverage their role in the healthcare system to improve care for opioid addiction and substance use disorders.
“We have been very concerned about the possibility that the Medicaid expansion and the enhanced match will be rolled back, which will result, we believe, in many states not covering the expansion population,” Murray says. “We know that Medicaid and (Children’s Health Insurance Program) cover 3 in 10 people with opioid addictions as of 2014, and that’s probably higher today. Medicaid covers medication-assisted therapy, substance abuse treatment and naloxone. The biggest takeaway is how important it is that people have access to the treatment and the drugs they need to address the opioid addiction.”