Use population health to fight substance abuse: Tips for MCOs

Because of rising cases of substance abuse in the United States, namely opioids, the American College of Physicians (ACP) released a list of recommendations for the healthcare community in order to decrease addiction and abuse.

The recommendations were released in a study published in the March 2017 issue of the Annals of Internal Medicine, and call for changes, including utilizing population health strategies, to identify and help patients who could be abusing prescription drugs.

Researchers found that in 2014, 22.5 million people in the United States needed treatment for an illicit drug or alcohol use problem, but only 18% received any treatment. In comparison, 77% of people with hypertension, 73% of people with diabetes, and 71% of people with major depression received treatment.

The costs of untreated substance abuse are a huge drain on the healthcare system as well, the study reports. Hospitalizations for opioid use rose from nearly 302,000 to more than 520,000 from 2002 to 2012, and costs for such care quadrupled to $15 billion in 2012. Charges for hospitalization for opioid use disorder with serious infections also quadrupled over the same time period to $700 million, according to the researchers.

Lessons for MCOs

Nitin S. Damle, MD, MS, MACP, ACP's immediate past president, says that decriminalization and destigmatization of substance abuse will help society to view it as a chronic disorder. That shift would allow healthcare leaders the opportunity to create strategies and databases to help people.

“We need to develop more behavioral health and substance use disorders therapists and facilities to care for these patients,” Damle says. “We also need to require insurance coverage for evidence-based treatment of substance use disorder, and support the prescription drug monitoring program on a national basis for prescribers.”

The ACP also recommends a national prescription drug-monitoring program (PDMP), and encourages states to use standardized reporting through the federal National All Schedules Prescription Electronic Reporting Act.

Next: How pop health data can help

How population health data can help

“The College strongly urges prescribers and dispensers to check PDMPs in their own and neighboring states (as permitted) before writing and filling prescriptions for medications containing controlled substances,” the report states. “All PDMPs should maintain strong protections to assure confidentiality and privacy. Efforts should be made to facilitate the use of PDMPs, such as by linking information with electronic medical records and permitting other members of the health care team to consult PDMPs.”

Damle says that managed care organizations and health plans can continue to educate staff on all levels about substance use disorders. Physicians should be encouraged to take continuing medical education courses in evidence-based prescribing and medication-assisted therapy, Damle says.

“They can identify patients at risk, those using controlled substances, provide a network of caregivers in the mental health and primary care community and integrate the care delivery,” Damle says. “They can analyze population-based data on use of services and prescriptions written, and track them over time.”