Health insurance

Health Insurers Developing Strategies to Tackle Drug Abuse

It can happen that individuals who are not themselves struggling with drug abuse and addiction problems can feel that these problems do not affect them.  Unfortunately, this is a terrible misconception, because drug abuse and addiction problems in our country affect everyone in some way, whether directly or indirectly.  The National Institute on Drug Abuse has reported that substance abuse and addiction problems cost our nation over seven hundred billion dollars each and every year in lost work productivity, crime and healthcare costs.  It is for this reason that efforts must be made to address and resolve these problems, as rapidly as possible.

Health Insurers Tackling the Drug Abuse Problem

According to the Boston Globe, health insurers are undertaking various strategies in an effort to help reduce the instances of drug abuse and addiction problems that are currently wrecking lives across the nation.  These companies bear a substantial portion of the costs related to drug abuse and addiction.  CeltiCare Health Plan, a Massachusetts-based company that mostly provides care to low-income individuals on Medicaid, has significant addiction-related costs.  Nearly twenty-five percent of all the hospital admissions CeltiCare covers are related to substance abuse problems.  CeltiCare has admitted that it will pay out approximately two and a half million dollars for the opiate addiction treatment medication suboxone.  This is more than CeltiCare will spend on any other drug.

In an effort to try and combat the problem of rising healthcare costs related to drug abuse and addiction problems, health insurers have increased restrictions on prescription drugs like Vicodin and OxyContin.  These two drugs are known to be particularly potent and addictive, and even individuals who take them exactly as prescribed often struggle with addiction problems shortly thereafter.  By placing restrictions on these drugs, health insurers feel that they may be heading off potentially costly addiction problems before they get underway.  Blue Cross Blue Shield of Massachusetts has taken to contacting any members who are in detoxification programs in order to help coordinate their care and treatment and prevent relapses from occurring.

While many of these changes may seem to be beneficial for all concerned, some doctors have already expressed their concern over the restrictions that they feel have been placed on how they can treat their patients.  Some have indicated that these new rules from health insurers have created burdens for them, and others have indicated that in order for the opioid epidemic to subside, something had to change. These changes may be uncomfortable at first, and may certainly force more doctors to “think outside the box”, but it may prove, in the long term, to be much more beneficial to their patients, and to the war against addiction.

Health insurers have also begun to assign case managers to patients who are in addiction recovery so that these individuals can help to guide them through the treatment process.  In some cases, they even partner with hospitals to help members stay sober.  Neighborhood Health Plan is the insurance division of Partners HealthCare and it has already teamed up with Massachusetts General Hospital.  Together, they are coordinating care for those members who in the past year have been diagnosed with substance abuse problems–nine percent of their total member base.

In many cases, the problems of drug abuse and addiction can be resolved by the individual receiving support and encouragement from others around them who have the skills, the know-how and the desire to help them overcome these problems.  It is hoped that by partnering healthcare with substance abuse treatment, health insurers may be able to not only save money but also improve their member’s overall health, which is the ultimate goal of healthcare in the first place.

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