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Insurers take steps to prevent drug addiction, treat addicts


With opioid abuse and addiction driving up healthcare costs, health insurers are helping to tackle the problem through a variety of strategies, according to the Boston Globe.

Massachusetts-based CeltiCare Health Plan, for example, says it will spend approximately $2.4 million on suboxone, a drug used to fight addiction--more than it will spend on any other drug. CeltiCare manages care predominantly for low-income people on Medicaid, and its addiction-related costs are significant, according to the Globe. Nearly a quarter of all hospital admissions the insurer covers are related to substance abuse. 

To address the problem, insurers have increased restrictions on prescription drugs like Vicoden and OxyContin, because addiction often starts with these medications, the article notes. And Blue Cross Blue Shield of Massachusetts now contacts its members who are in detox programs in an effort to prevent relapses and coordinate their care, the article says.

Some doctors, however, are skeptical of restrictions placed on how they treat their patients. Some have already come forward to say that the insurers' rules have created burdens for physicians, but others have said that things much change if the opioid epidemic is to subside, the Globe notes.

Insurers also assign case managers to patients to help guide them through treatment, in some cases partnering with hospitals to help members stay sober. Neighborhood Health Plan--the insurance division of Partners HealthCare--has teamed up with Massachusetts General Hospital to coordinate care for the nearly 9 percent of its members who have been diagnosed with substance abuse in the past year, according to the article.

By integrating substance abuse programs into the healthcare system, insurers can not only save money in the long run, but also improve overall health in the general populationFierceHealthPayer previously reported. Yet because drug addiction isn't treated like a chronic disease, insurers often don't fully cover treatment options.

To learn more:
- read the Boston Globe article

Related Articles:
Treating and preventing opioid abuse saves money in the long run
Humana study shows success of linking population health, substance abuse treatment
Insurers fall short when it comes to covering substance abuse treatment