16 Insurance Companies Make Commitment To Address Opioid Crisis

16 Insurance Companies Make Commitment To Address Opioid Crisis

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If confronting the opioid crisis were like playing in the World Series, yesterday’s announcement may be akin to hitting a home run, maybe even a Grand Slam.

On Wednesday, Gary Mendell, Founder and CEO of Shatterproof, Dr. Thomas McLellan, former Deputy Director of the Office of National Drug Control Policy, Chris Hocevar, President (Strategy, Segments and Solutions) of Cigna Corporation, and Mary Ann Christopher, Vice President (Clinical Operations and Transformation) of Horizon Blue Cross Blue Shield New Jersey, announced that 16 major healthcare payers would adopt eight “National Principles of Care” for the treatment of addiction.

Unless you have been staying in the locker room all this time, you’ve probably heard that addiction to opioid medications has become so widespread that it’s a national crisis (and recently declared a nationwide public health emergency). However, a concern is that many efforts to address the crisis have been stuck in the player lineup announcement phase. In other words, things have been a bit like that scene in Monty Python’s Life of Brian movie where a council keeps discussing why they should be taking immediate action but never actually takes any action.

Wanting to get everyone on to the field to tackle the opioid crisis (yes, I know there’s no tackling in baseball), Mendell and Shatterproof helped convene the Substance Use Disorder Treatment Task Force in April 2017. Securing commitments from the following 16 healthcare payers is the latest step taken by this task force:

    1. Aetna
    2. AmeriHealth Caritas Family of Companies
    3. Anthem, Inc.
    4. Beacon Health Options
  1. Blue Cross Blue Shield of Massachusetts
  2. CareOregon
  3. CareSource
  4. Centene Corporation
  5. Cigna
  6. Commonwealth Care Alliance
  7. Envolve Health
  8. Horizon Blue Cross Blue Shield of New Jersey
  9. Magellan Health
  10. UnitedHealth Group
  11. UPMC Insurance Division
  12. WellCare

This group includes 6 of the largest payers in the United States, covers over 248 million patient lives, and has provided letters of commitment and signed a memorandum of understanding to advance the following eight “National Principles of Care”:

  1. Universal screening for substance use disorders across medical care settings
  2. Personalized diagnosis, assessment, and treatment planning
  3. Rapid access to appropriate Substance Use Disorder care
  4. Engagement in continuing long-term outpatient care with monitoring and adjustments to treatment
  5. Concurrent, coordinated care for physical and mental illness
  6. Access to fully trained and accredited behavioral health professionals
  7. Access to Food And Drug Administration (FDA)-approved medications
  8. Access to non-medical recovery support services

As Mendell and McLellan both explained, these eight principles aren’t new and instead essentially emerged from Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health from 2016 that included recommendations resulting from an extensive review of the scientific literature. The task force made some minor wording changes and added the first recommendation (screening everyone for substance use disorder) to the seven other principles drawn from the previous Surgeon General’s report.

Seven of the eight principles of care draw directly from a report led by Dr. Vivek Murthy. while he was Surgeon General of the United States last year. (Photo by Jessica McGowan/Getty Images)

“We already know what science says to do,” Mendell emphasized. “It is a matter of doing it.” As I described previously for Forbes, Mendell had founded and built a hotel business and is now using similar business principles in systematically building and executing a game plan against the opioid crisis.

In assembling these major payers, the task force aims to address a major problem fueling the opioid crisis: there is little consistency in what health care providers and facilities and treatment programs are doing. Many are not following recommendations from years of scientific research. Mendell said, “Two-thirds of treatment programs don’t even follow scientific evidence-based guidelines. 14,000 plus treatment programs are all doing their own thing.”