Report: Three-fifths of insurers seek to boost alternative pain management treatments

Morgan Haefner - Print  | 

A historically low national uninsured rate of about 9 percent puts "insurers in a position of financial and ethical significance to combat the opioid epidemic," according to a report by the Center on Health Insurance Reforms, based at Georgetown University Health Policy Institute in Washington, D.C.

The report, funded by the Robert Wood Johnson Foundation, included a literature review and 14 interviews with representatives from commercial insurers, healthcare providers, pain management providers and patient advocacy groups. Researchers chose insurers promoting their opioid misuse reduction policies and said the findings may not represent all commercial payers. Interviews were conducted between October 2016 and February 2017.

Here are five takeaways from the report.

1. Providers and some patient advocates have argued payers contribute to the opioid epidemic through benefit limits on nonopioid rehabilitative treatments that may incentivize physicians to overprescribe opioids, according to the researchers.

2. Insurers interviewed for the study said they instituted policies aimed at combating opioid overprescription and are using data to track high-prescribing providers and at-risk patients.

3. Three of the five insurer respondents are trying to limit opioid overuse by increasing use of other chronic pain treatments, and only one insurer of the five has a comprehensive plan, according to the study.

4. A number of respondents from insurers, providers and patient advocacy groups said a shortage of pain management specialists contributes to the opioid epidemic.

5. The study concluded the interviews "provide examples of insurer efforts to reduce opioid prescribing and the gaps or barriers of insurance coverage to treat people with chronic pain. None of these efforts will end the epidemic on their own, but combined initiatives to expand behavioral health services for substance use disorders and other actions by payers, the medical community and state and federal policymakers can play an important role in reducing opioid deaths." 

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