Dive Brief:
- Several national and Massachusetts health insurers are working to curb opioid abuse by providing some patients with the support of social workers or recovery coaches.
- The Association of Community Affiliated Plans told NPR some of its members across the U.S. are utilizing social workers to help those patients maintain their treatment to avoid relapse and rehospitalization.
- One of the plans, Neighborhood Health Plan in Boston, created algorithms to target at-risk enrollees for social workers to contact.
Dive Insight:
The move makes sense in the context of the cost some health plans currently face in relation to opioid addiction.
CeltiCare Health Plan in Massachusetts told NPR it had found almost a quarter of its hospital admissions to stem from substance use and spent more on Suboxone to treat narcotic addiction than it did on any other medications. That leads some insurers to suggest the cost of recovery support will more than pay off in the end.
"At the end of the day, we think it's going to cost a lot less," CeltiCare's president and CEO Jay Gonzalez told NPR. "They're going to be healthier; they're not going to be showing up in the emergency room. We have people who show up in the emergency room 50 to 100 times a year. That's very expensive, and it's not good for the member."
In order to work, however, plans note such a move requires the trust of the patient.
Neighborhood Health Plan's chief medical officer Dr. Paul Mendis says they start by reaching out to at-risk people based on other medical diagnoses to ease contact, though they are also piloting a process to connect with patients who suffer overdose.