BlueCross BlueShield of Tennessee is fighting on a number of fronts against the opioid crisis, and the efforts are beginning to show meaningful double-digit reductions in painkillers prescribed and abused.
The company, guided by an external advisory panel of doctors and medical professionals, worked to reduce the supply of opioids by implementing measures such as prior authorization requirements and quantity limits. In 2017, those changes resulted in 194,000 fewer opioid prescriptions filled - an equivalent of 12 million pills. That represents a 6 percent decrease in the overall number of opioid prescriptions per member, per month.
For long-acting opioids claim numbers dropped 52 percent from 2016 to 2017. Short-term opioid use also dropped among BlueCross members, and lower strengths of opioids (Morphine Equivalent Dose) are being used.
"We are excited about our positive momentum, and we look forward to more collaboration with our government, provider and community partners to continue this progress," said Dr. Andrea Willis, chief medical officer at BlueCross.
For members, the company has focused on building integrated medical and behavioral health care support offerings, as well as specialized care for expectant mothers who are opioid-dependent.
The company has also worked closely with providers, offering data-driven scorecards to help physicians understand how their prescribing patterns compare to peers and providing notifications about patients who are at high risk for opioid abuse. Providers whose prescribing patterns consistently diverge from best practices are removed from BlueCross networks.
"Pain relief is important, but it's clear that both overprescribing and extended periods of opioid use can increase the risk of addiction," said Natalie Tate, vice president of pharmacy for BlueCross. "We will continue to focus on ensuring that providers follow best practices in prescribing - and that they consider alternate pain medications and treatments for patients whenever possible."
In addition to pharmacy initiatives, BlueCross has also supported a variety of community-based efforts to address the issue. These efforts began in 2013 with a focus on supporting babies with neonatal abstinence syndrome, and continued with $2 million to support addiction treatment programs statewide. A $2.7 million award to Count It! Lock It! Drop It! helped educate the public about the need to count pills regularly, lock them up and securely dispose of unused medications.