Mobilizing Health Plans to Make Progress on Opioid Addiction

Gary Mendell and Shatterproof have it right. They are spearheading an effort to work with health plans to improve opioid addiction treatment by getting agreement on some basic principles: People dealing with opioid addiction in themselves or a family member need rapid access to reliable, evidence-based treatment without barriers. Access to medication assisted treatment (suboxone and methadone) and overdose reversal medication (naloxone) should be available as needed. The evidence of the effectiveness of these medications is very clear and growing stronger as more research is completed. But, as data from the National Institute of Drug Abuse shows, most people who need treatment don’t get it, by a long shot: In 2015 22.5million Americans clinically needed treatment for substance use disorder. But only 4.2 million received some type of treatment and only 2.6 million received specialty addiction services.

The health plans have the power to improve these numbers. They also have the opportunity to be sure that their network health care providers are prescribing opioids correctly to begin with, that they are routinely screening for substance use disorder and that they have an adequate network of physicians who can prescribe medication assisted treatment. They also need to have an adequate network of high quality treatment facilities available as soon as the need for treatment is identified. Thanks to Mr. Mendell for his leadership on this important area. Employers have an opportunity to play a very powerful role in getting this right by requiring this level of performance from their health plan and other healthcare vendors.

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