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CareFirst BlueCross BlueShield, Mayor Pugh announce new efforts combating opioid, substance use

Posted at 3:50 PM, Dec 13, 2017
and last updated 2017-12-13 18:00:48-05

CareFirst BlueCross BlueShield in partnership with Mayor Catherine Pugh's office announced new efforts to combat the opioid crisis in the Baltimore area.

The efforts include $1.5 million in funding for non-profit community organizations for programs aimed at addressing substance use disorders, as well as new prescribing limits and treatment programs to limit opioid abuse and improve care for members battling addiction.

“The impact of opioids in the region we serve has been well documented,” said CareFirst President and Chief Executive Officer Chet Burrell.

“As the region’s largest health insurer and one with a unique community mission, we want to take a comprehensive approach to address the opioid crisis for the greater community, as well as to create and promote policies and programs for our members that address addiction and its disastrous health impacts on the individuals and families we cover.”

“Far too many individuals are familiar with the toll on our community caused by the use and abuse of opioids. It takes a toll on individuals, families, and the entire community," said Baltimore Mayor Catherine E. Pugh.

"The Baltimore City Health Department has developed a comprehensive, three-pillar strategy to combat opioid addiction: prevent deaths from overdose and save lives, increase access to on-demand treatment and long-term recovery support, and provide education to reduce stigma and prevent addiction,”

CareFirst is taking a number of steps to address opioid and substance use disorders.

They will fund community-based initiatives. In January, CareFirst will issue a request for proposals  to community non-profit organizations. A total of $1.5 million will be awarded for programs and initiatives designed to directly address opioid use, addiction, and related issues.

CareFirst has in place and continues to develop a network of high-performing addiction recovery centers. They provide intensive outpatient programs, highly individualized treatment, including relapse prevention, coping strategies and medication assisted treatment.

Because many individuals with addiction have multiple medical and behavioral health disorders, CareFirst has developed a Behavioral Health and Substance Use Disorder program. In the program, members are assessed and connected to specially trained clinicians who work one-on-one with patients to identify mental health providers, assist with access, and coordinate their overall care.

They are also looking into new quantity and duration limits for patients who are prescribed painkillers. This has already started. Based on Centers for Disease Control Guidelines for the Management of Chronic Pain, CareFirst implemented in October year new requirements related to opioid prescription quantity and duration limits. 

CareFirst will enhance prescription drug monitoring. Right now it monitors controlled substance pharmacy data to identify members with multiple prescribers/pharmacies, excessive use and high claims costs which indicate behavior patterns that signal possible misuse. Pharmacists notify providers of the member’s utilization history and work with them to outline and address concerns.

“All of these efforts are intended to work together, both to address what has become a public health crisis, and beyond that to treat addiction for what it is – a chronic disease,” said Dr. Daniel Winn, CareFirst Senior Medical Officer and Vice President.