Tackling Substance Abuse, Opioid Crisis: How Health Insurance Providers are Increasing Access to Addiction Treatment

Tackling Substance Abuse, Opioid Crisis: How Health Insurance Providers are Increasing Access to Addiction Treatment

Publication date: Dec 25, 2019

In a news brief published by AHIP , initiatives employed by health insurance providers AmeriHealth Caritas, Geisinger, Horizon Blue Cross Blue Shield of NJ (BCBSNJ), and UPMC plan to address issues ranging from the opioid crisis to behavioral healthcare access. The impact of substance use disorders (SUD) and the opioid crisis have substantially affected the healthcare system, social services, communities, and the economy, with substance abuse being attributed to costing the US $740 billion annually through crime, lost work productivity, and healthcare.

Addressing these concerns, health insurance providers are employing strategies to increase capacity for SUD treatment, while also ensuring that members have access to high-quality treatment and care. Developed by AmeriHealth Caritas, the -New Beginnings: Addiction and Recovery Medical Home” SUD program serves to improve preventive treatment for opioid abuse through a bundled payment approach that provides innovative solutions for addiction and recovery services for those most in need.

Often, a health insurance provider becomes aware of a patient’s SUD when the member has overdosed and is admitted to an emergency department, but through its SUD program, health systems are implementing new strategies that improves patient engagement in treatment and recovery services to combat the opioid overdose epidemic. The model will deliver treatment to patients through a team of primary care providers, behavioral health providers, and SUD specialists, that will prioritize multidisciplinary care.

The pilot project seeks to ensure access to care for patients who have historically experienced fragmented care or uncoordinated services, highlighting Horizon BCBSNJ’s commitment to addressing underlying behavioral health issues. Providing quality care to patients with SUD or OUD is hindered amongst physicians due to stigmas or insufficient training, however, the absence of the required DEA waiver to prescribe some MAT remains a major obstacle for willing providers.

Concepts Keywords
Addiction Mental health
Ambulatory Drug rehabilitation
Behavioral Health Opioid use disorder
Caritas Concerns insurance providers
DEA Behavioral services
Department Addiction behavioral services
Epidemic Program systems
Healthcare Productivity healthcare
Hotline Healthcare company analytics
Insurance Mental illness services
Mental Illness Mental illness
Nurse Practitioners Substance dependence
Opioid Substance-related disorders
Opioid Epidemic Articles
Opioid Overdose Social issues
Peer Support Sackler family
Physician Assistants
Primary Care
Social Services
Substance Abuse


Type Source Name
drug DRUGBANK Ethanol
disease MESH suffering
drug DRUGBANK Ilex paraguariensis leaf
disease MESH Substance Abuse
disease MESH communities
disease MESH opioid abuse
disease MESH emergency


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