Independence Blue Cross President: How We Curb the Opioid Epidemic

Philadelphia has the purest and cheapest heroin in the country and a long history of multigenerational heroin addicted families. Last year, we lost more than 1,200 people to overdose deaths in our city alone. Clearly, this problem requires the collective effort of our entire region.

For years, Independence Blue Cross has worked with doctors to alert them when they are prescribing outside the CDC guidelines to help prevent their patients from getting addicted to opioids. Last year, Independence took a bold step by becoming one of the first insurers in the country to limit all new opioid prescriptions to five days. This policy change resulted in a substantial reduction in opioid use and prescriptions: during the last six months of 2017, the number of members using opioids dropped 22% and the number of prescriptions dropped 26% compared to the same time in 2016.

In response to evidence on the important role of medication assisted therapy in recovery, we continued coverage for buprenorphine and naltrexone without precertification and added coverage for methadone, also without precertification.

We are also working with hospitals to support warm hand-offs, which connect people who have just overdosed on opioids to resources, including immediate access to a certified recovery specialist. A study commissioned by the Independence Blue Cross Foundation that looked at the effectiveness of these warm hand-off programs will be an important benchmark for measuring the success of this critical piece of the recovery process.

One of the most formidable partners to fight opioid abuse is our community itself. There is a large and impressive army of people in every corner of our region doing their part to connect people to treatment and resources, and above all, offer hope.  An important part of that work is making the lifesaving overdose reversal drug naloxone, or Narcan, more accessible.  Independence has done that in a few ways, including funding additional Narcan for Philadelphia emergency personnel and by removing cost sharing for naloxone for our members earlier this year.

The numbers alone-more than 70,000 overdose deaths in the U.S. in 2017- tell a convincing story about the horrors of this disease. But the numbers cannot possibly communicate the devastation the opioid crisis has had on real people like Marissa, who lost her teenage son to an overdose. Or on Michael, Mary, and Devin, who fought and overcame their opioid addictions, and now help others get the support they need.

Related: Do Controlled Substance Agreements Improve Care Quality for Opioid Patients?

These are a few of the real-life stories we have been telling through the Independence Blue Cross Foundation as part of the “Someone You Know” public awareness campaign, in collaboration with the Justice Center for Research at Penn State University. These powerful vignettes put a human face on this crisis, primarily aiming to de-stigmatize opioid abuse. In conjunction with the campaign, a series of local conversations about mental health and trauma as part of substance recovery provided an outlet for even more people to tell their story in a safe and welcoming place.

A highlight of the campaign was a national conference, hosted by our foundation on October 16. This event showcased these stories, as well as a discussion with U.S. Surgeon General Jerome Adams, MD, MPH, and other local, regional and national leaders about opioid prevention, treatment, and recovery.

We are also collaborating with local legislators and advocates on a number of key public policy changes to improve care coordination and patient treatment. This includes protecting patient rights by addressing disreputable patient brokering that steers insured individuals with substance use disorders into certain treatment facilities or sober homes in exchange for commissions or payments.  Additionally, we want to ensure more timely sharing of information between substance abuse treatment providers and primary care physicians, such as a patient’s recent detox or inpatient stay. This flow of information is critically important to protect patients in recovery but currently limited by federal law.

We have a long way to go to prevent unnecessary opioid use, abuse, and overdose, so our work won’t end here.  We will continue to find new ways to partner with others until the numbers tell a different, and better, story.

Daniel J. Hilferty is the president and CEO of Independence Blue Cross.