Health Care and Human Resources

Health insurer reports opioid usage 'plummets'

May 13, 2019
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Priority Health doctor and patient
Priority Health says its network of providers features 95 percent of practicing physicians available in Michigan. Photo via fb.com

A local health insurer is reporting decreased opioid use among its members across all business lines.

Grand Rapids-based Priority Health analyzed a year of numbers following the November 2017 launch of a program focused on increasing opioid awareness, making “rescue” medicine like Naloxone more available and improving access to medication-assisted treatments and behavioral health services.

Priority Health’s commercial members saw a 47% reduction, Medicaid members had a 36% reduction and Medicare members had an 18% reduction, according to the insurer last month.

“We can’t reverse the opioid epidemic until we reduce entry into opioid use, improve and promote access to non-opioid alternatives for chronic pain and ensure that opioids are taken by people who really need them, not those who don’t,” said Dr. James Forshee, SVP and chief medical officer, Priority Health.

“We are excited to see how much change has happened in a short amount of time, but there is much more to be done, and we are looking at how we can continue to build on the progress we’ve made.”

The insurer’s strategy included improving access to behavioral health services, limiting the number of short-acting opioids for acute pain to a 15-day fill, limiting the number of long-acting opioids for chronic pain to a 30-day fill, reducing the maximum daily dosage and reducing the number of members receiving prescriptions from multiple doctors.

“While we follow evidence-based recommendations to help our population, our approach considers how social determinants of health may impact medical outcomes, ensuring the member’s care plan includes the full range of services required for them to get healthy and stay healthy,” Forshee said.

While Priority Health saw decreased usage within its membership population in early 2018, the insurer recognizes that other stakeholders, such as Michigan lawmakers, have played a role in helping reduce usage.

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