Massachusetts Health Insurers Take Aggressive Steps to Combat Opioid Addiction

Several Massachusetts health insurance companies are taking aggressive steps to combat opioid addiction, NPR reports. These steps include assigning social workers to some patients.

Jay Gonzalez, CEO of CeltiCare Health Plan, which mostly manages care for Medicaid patients, says hiring social workers is key to addressing the opioid epidemic. He notes after patients are discharged from inpatient substance use treatment and detox, relapse and readmission are likely unless patients receive follow-up support.

“This is the biggest potential solution to this problem, I think, because at the end of the day we have to find the members who are or could be in trouble, and we need them to be invested in addressing their issues,” he said.

Almost one-fourth of CeltiCare’s hospital admissions are related to substance use. The company spent more than 10 percent of its budget last year on the addiction medication Suboxone—more than any other drug.

Gonzalez is hopeful that paying extra attention to patients being treated for addiction will pay off in the long run. “At the end of the day, we think it’s going to cost a lot less,” he said. “They’re going to be healthier; they’re not going to be showing up in the emergency room. We have people who show up in the emergency room 50 to 100 times a year. That’s very expensive, and it’s not good for the member.”

The health insurance company is also training some members and their families in how to use the opioid overdose antidote naloxone. CeltiCare is also instituting stricter limits on initial prescriptions of opioid painkillers. Currently, patients initially cannot be prescribed more than a 15-day supply of opioids. That will be reduced to a seven-day supply next month. Doctors will be allowed to renew prescriptions as they see fit.

Blue Cross Blue Shield of Massachusetts has been limiting the supply of opioids allowed in an initial prescription for the past three years.