Misuse and abuse of prescription medications in the United States is a serious public health problem. The opioid crisis continues to have significant impact on families, communities, and the healthcare system. From 2000 to 2016, there were more than half a million deaths from drug- and opioid-involved overdoses, with 115 Americans dying every day from an opioid overdose.
This burden of opioid use disorders (OUD) and resulting crisis has disproportionally impacted low-income and disabled individuals and the programs and resources that support them, many of which are financed by Medicaid. As the crisis continues to unfold, many ACAP Safety Net Health Plans are addressing these issues on several fronts. They have forged deep relationships with their communities—including patients, providers, policymakers and public health officials—by engaging in collaborative conversations around preventative measures and effective treatments and interventions.
Effective strategies have emerged from these conversations, including processes for engaging primary care providers (PCPs) in prevention, detection and treatment of OUD through the deployment of Medication-Assisted Treatment (MAT) and the integration of physical and behavioral health. MAT combines behavioral therapy and the administration of three medications—methadone, buprenorphine, and naltrexone—to treat substance use disorder (SUD). The evidence supports the effectiveness of MAT in treating opioid and alcohol use disorders. However, despite its impact, only about 1 in 10 Americans who seek MAT can receive it, due in part to a shortage of buprenorphine prescribers and addiction specialists.
This paper provides a practical perspective on how health plans can support and engage PCPs to increase MAT prescribing. As primary payors for health care services, including prescription drugs in most states, health plans play a critical role in addressing the opioid crisis.