Trending
PARKERSBURG -- Highmark on Thursday announced the expansion of programs addressing opioid addiction in Pennsylvania and West Virginia.
The programs will focus on assisting providers with pain management and safe opioid prescribing and changes to prescription policy, Deborah Rice-Johnson, president of Highmark, said. The addiction is a crisis that Highmark is using all its resources to address it and working with other organizations, Rice-Johnson said.
"We can do a lot together," she said.
The company with axialHealthcare will supply providers with information to address pain management outside of the use of opioids, such as physical therapy, acupuncture or chiropractic, and mental health treatment, Rice-Johnson said.
Consideration has to be given to patients who need the medication because non-drug treatments don't work and there must be access to other therapies, she said.
The tools will give providers insight into their opioid prescribing patterns and guidance on clinical best practices for opioid prescribing, and provide access to patient safety alerts, care pathways for treating common pain complaints, and in-network referral support for complex cases that require personalized, high-quality care for pain or opioid misuse, the company said.
The program was implemented in West Virginia and has been successful, she said. More than 250 providers received extensive, targeted clinical consultation on pain management.
Patients receiving opioids from multiple prescribers dropped by more than 28 percent, and patients receiving opioids with certain sedatives, a significant risk factor for opioid overdose, fell more than 25 percent, Rice-Johnson said.
Highmark is confident of a good impact in Pennsylvania because of the results from West Virginia, Dr. Charles DeShazer, chief medical officer for Highmark, said.
"That is why we are expanding the program to Pennsylvania," he said. "We expect positive results here, just as we have seen in West Virginia."
On Feb. 1, Highmark and axialHealthcare for providers in West Virginia and Pennsylvania started a program to give them opioid-related risk information of patients in real-time so better informed decisions can be made.
In March, Highmark will implement a new policy for commercial members who are prescribed opioid-based medications for the first-time. It will impose a seven-day limit on the supply of medication.
The change will include new prescriptions for extended release opioids for members who have not been recently on an opioid, Sarah Marche, vice president of pharmacy services, said. A new prescription for extended release opioids will not be allowed without a prior authorization, she said.
According to the Centers for Disease Control, opioids taken only one day creates a 6 percent chance of addiction, she said. The chance raises to 13 percent for someone on opioids for more than a week, Marche said.
Limiting the amount could reduce the number of people who become addicted, she said.
"This approach is consistent with the recently released CDC safe prescribing guidelines," Marche said.
The policy is intended to help people who have never used opioids to reduce the risk of dependence and, because of quantity limits, prior authorizations and overuse monitoring, encourages an appropriate use by members on chronic opioids, Marche said. The aim of the program is to stop inappropriate, long-term use of opioids, she said.
Patients who have chronic pain that cannot be managed otherwise or may need opioids for acute or chronic pain associated with cancer or other malignant conditions exceptions, Marche said.