Data Help Michigan, Tennessee Blues Combat Opioid Crisis

From Health Plan Weekly

Blues plans in Michigan, Tennessee and other states are testing new strategies to combat opioid addiction in their regions, even as President Trump signed the spending bill that releases new funds to fight the crisis.

As overdose deaths in Michigan involving prescription opioids have tripled since 2012, Blue Cross Blue Shield of Michigan has a commitment from the top down. Starting with data, the insurer uses pharmacy and utilization management programs, empowers providers, works with state and national lawmakers and offers financial support to communities, according to Tom Leyden, director of the value partnerships program at the Michigan Blues plan.

Leyden adds that they also made changes in benefit and coverage limits to build "a safe, strong and accountable network."

Their efforts saw a 42% reduction in fentanyl use and a 27% reduction in opioid expenditures in the last six years.

BlueCross BlueShield of Tennessee says the quickest and simplest way to effect change is making changes to the formulary. The insurer expands and modifies opioid quantity limits, requires prior authorization for all patients getting long-acting opioids and covers abuse deterrents and medication-assisted treatments.

The changes over the past two years led to a 6% reduction in opioid claims and a 10% reduction in average morphine-equivalent dose (MED), says Andrea Knight, Pharm.D., director of corporate pharmacy affairs at BlueCross BlueShield of Tennessee.

Their program "Count it! Lock it! Drop it!" focusing on public education on the danger of addictive medications has spread from just one county in the state to all 95 counties. Eight states have instituted the program.

Highmark Inc. partners with axialHealthcare to offer decision support tools based on data analytics and consultation in Pennsylvania, providing doctors with information on patients' opioid prescribing patterns and practices to avoid addiction.

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