Matthew Collins, M.D., MBA, Vice President, Clinical Integration
Blue Cross & Blue Shield
of Rhode Island
national efforts to combat the opioid crisis, it remains a widespread health
issue in America. In its most recent Health of America report – The
Opioid Epidemic in America: An Update – the Blue Cross Blue Shield
Association (BCBSA) found that while progress has been made – the total number
of opioid medications filled by commercially insured Blue Cross Blue
Shield (BCBS) members across the country has declined by 29 percent since 2013 –
there were still 241,900 BCBS members diagnosed with an opioid use disorder
(OUD) in 2017.
report also highlights individual findings from each state, and Rhode Island
has been particularly hit hard by the opioid crisis. In fact, Rhode Island is
tied with Connecticut for the 8th highest
opioid use disorder diagnosis rate nationally (nine per 1,000 members).
However, the report does have some promising data demonstrating the positive
impact of work already underway:
Island has the second highest reduction rate (46 percent) in opioid
prescriptions per 1,000 members from 2013-2017.
• Rhode Island is tied with
Massachusetts for having the highest percentage of members (57 percent) with
prescriptions lasting fewer than eight days’ duration.
marker is especially important as doses longer than seven days are
considered high dose and high duration by the CDC and may lead to a higher
likelihood of patients being diagnosed with OUD in the future.
In 2017, 67 percent of BCBS members filled
their first opioid prescription within the CDC-recommended guidelines for both
dose and duration. Rhode Island led the way at 80 percent.
there’s still a lot of work to be done. BCBS plans across the country are
collaborating to find reliable support for members – and all Americans
suffering from opioid use disorders – and are collaborating with clinical and
program experts to assess the effectiveness of treatment options and improve
access to quality treatment services.
local efforts, the BCBSA board of directors has committed to advancing the
safety and effectiveness of treatment for opioid use disorders. As part of that
commitment, BCBSA will launch Blue Distinction® Centers
for Substance Use Disorder Treatment and Recovery to ensure members have access
to the best evidenced-based approaches in addressing the long-term issues
associated with opioid use disorders. The BCBSA also agreed to establish a
national hotline to connect those in need with treatment centers. The hotline
is slated to be available in 2020 to both BCBS members and non-members alike.
in Rhode Island, BCBSRI has supported the efforts of the Governor’s Opioid
Overdose Task Force to develop and implement strategies aimed at prevention,
treatment, rescue and recovery. BCBSRI has embedded pharmacists in our
patient-centered medical homes to help manage opioid use and provide
alternative, non-opioid solutions for patients with acute and chronic pain. We
have reduced opioid prescriptions and are collaborating with medical professionals,
employers and communities to address gaps in the continuum of care.
recently partnered with the Addiction
Services Center at Roger Williams Medical Center to
deliver medication-assisted treatment to Rhode Islanders struggling with opioid
use disorders. We also bundled all services so that members only have to make
one copay per month - an important step to encourage more people into care
management and treatment programs. We have also partnered with Beacon Health
Services, whose case management programs assist members in accessing and
engaging in treatment and recovery. And, we’ve partnered with Anchor Recovery,
whose peer support program has enrolled 300 members since January.
is also implementing policy changes. Effective January 1, 2019, copayments for
behavioral health office visits will be consistent with primary care office
visits. As of August 1, 2018, BCBSRI also removed approval requirements (also
known as utilization review) for in-network behavioral health services.
Concurrent with this change, BCBSRI is shifting to a care management model that
is focused on developing quality measures to ensure our members get the best
care. And, we are providing education support and advocacy for members
navigating both an illness and the healthcare system.
2018, the Governor’s
Opioid Overdose Task Force focused on the theme of communities coming
together and highlighted the role of connections. The epidemic calls upon all
of us to work together to combat this critical health issue. It’s up to
us as Rhode Islanders to help tackle this crisis from the grassroots level in
our own communities.
the healthcare partner to one in three Americans, Blue Cross and Blue Shield
companies stand committed to our communities and to fighting
America’s opioid crisis through several national initiatives. Here in
BCBSRI is collaborating with state leaders, providers and community partners to help
improve access to quality, affordable behavioral healthcare, especially care
that addresses substance use disorders.