CareSource, a nonprofit managed care organization, announces it has reduced the amount of opioids prescribed to its members by 40 percent in the last 18 months as a result of an innovative program working with doctors and prescribers. By the end of 2018, CareSource will have cut that amount in half.
“We believe that managed care plans can play a key role in fighting the opioid epidemic,” said Jonas Thom, Vice President of Behavioral Health at CareSource. “We know that helping members get on a path to recovery and self-sufficiency leads to better outcomes.”
With 1.8 million Medicaid members, CareSource is in a position to respond to the opioid epidemic by providing oversight of prescriptions.
In 2016, CareSource implemented a prescriber outreach program to notify providers who are prescribing high amounts of opioids to members. Using claims data, CareSource can identify members at risk for substance use disorder, diversion, overdose or other adverse events and alert providers.
CareSource analyzes the volume of opioids being prescribed to its members as measured by Morphine Milligram-Equivalent Doses (MED), which accounts for the number of pills, dosing schedules and strength.
CareSource also sends letters to prescribers illustrating how their overall MED prescribing compares to their peers, then highlights strategies to reduce opioids in their practices.
The overall initiative, entitled “MED Letters,” won a Pinnacle Award from the Ohio Association of Health Plans and is just one piece of CareSource’s entire Behavioral Health strategy. The company also has:
- Reduced the number of 30-day opioid prescriptions by 30 percent.
- Increased the number of participating providers offering Medication Assisted Treatments such as Buprenorphine, Naloxone or Vivitrol, etc. by more than 50 percent.
- Expanded pharmacy lock-in to decrease the practice of doctor and pharmacy shopping.
- Expanded benefits to include transportation to recovery services.
- Focused case management to remove additional barriers to becoming self-sufficient, such as employment, child care and vocational training.
This year, CareSource will also begin monitoring adolescents and young adults for opioid risk. In Ohioalone, people younger than 34 accounted for 38 percent of the total opioid overdose deaths in 2016.
“We have certainly had a meaningful impact on our members’ lives and the opioid crisis through our targeted programs, but there is more to be done,” said Thom.
About CareSource
CareSource is a nonprofit nationally recognized as an industry leader in providing member-centric health care coverage. Founded in 1989, CareSource administers one of the nation’s largest Medicaid managed care plans. Today, CareSource offers individuals and families comprehensive health and life services including Marketplace and Medicare Advantage plans.
Headquartered in Dayton, Ohio, CareSource serves nearly 2 million members in Ohio, Kentucky, Indiana, West Virginia and Georgia. CareSource understands the challenges consumers face navigating the health system and works to put health care in reach for those it serves.
For more, visit caresource.com, follow @caresource on Twitter, or like CareSource on Facebook.
