TMCnet News

Anthem More Than Doubled the Members Receiving Whole-person Treatment for Opioid Use Disorder
[September 15, 2020]

Anthem More Than Doubled the Members Receiving Whole-person Treatment for Opioid Use Disorder


Anthem Blue Cross and Blue Shield more than the doubled the number of members in Medicaid, individual and employer-sponsored plans receiving whole-person therapies believed to produce better outcomes for opioid use disorder.

To make a positive impact on member health and lessen the impact of the opioid epidemic, Anthem pledged four years ago to ensure significantly more members received both drug therapy and counseling treatment in an effort to treat both mind and body.

Anthem met these goals by boosting the combined percentage of consumers in employer-based, individual and Medicaid plans with opioid use disorder receiving both therapies from 22 percent to 56 percent receiving both therapies. Medicaid plans alone increased from 24 percent to 65 percent.

The goal was met just as the country commemorates National Recovery Month, which recognizes people who are in recovery and those who support them. Increasing the number of consumers receiving both therapies becomes even more relevant as Indiana and the rest of the country struggle with the COVID-19 pandemic. The White House Drug Policy issued a recent analysis showing that drug overdose deaths are up 11 percent for the first four months of 2020 during the pandemic compared to the same time last year.

"A holistic treatment strategy involving medications, counseling, and lifestyle changes is essential for long term recovery from opioid use disorder," said Dr. Gus Crothers, an addiction specialist and national medical director for Groups Recover Together, which has more than two dozen locations in Indiana. "The medications provide biologic stability while counseling and lifestyle changes address the psychological and social aspects of the disease. We are glad to support Anthem in its goal to increase access to this high-quality approach for its members."

Anthem is committed to supporting holistic policy changes that help reduce, prevent and deter opioid use disorder, as well as those that help consumers gain better access to opioid use disorder treatment and assist in their recovery. Anthem health plans, working in tandem with pharmacy, already have been successful i lowering the number of opioid prescriptions filled by more than 53 percent since 2015 when prescriptions peaked.



"Opioid use disorder is a complex societal issue that will take focus and persistence to resolve," said Beth Keyser, president of Anthem Blue Cross and Blue Shield in Indiana. "By breaking down silos and fostering greater collaboration with our care providers and other national patient and industry organizations, we are confident that together we can find solutions to help ensure our consumers have access to the best evidenced-based care for substance use disorder."

Keyser will speak at the Indiana Employer Opioid Summit September 16.


Four years ago, Anthem research of pharmacy and medical claims found that only 22 percent of members taking buprenorphine or naltrexone were also getting the clinically appropriate counseling to successfully change behavior and assist in recovery from addiction. Anthem then committed to work intensely with care providers and others to implement programs to close the gap and encourage counseling as part of all medication assisted treatment, or MAT, services.

The American Society of Addiction Medicine and Substance Abuse and Mental Health Services Administration both advocate the use of counseling in combination with drug therapy to treat people with substance use disorder.

"Through our research, we determined there were key barriers to consumers getting the therapy they need - availability of local care providers participating in MAT, appropriate screenings at the primary care provider, and innovative approaches to recovery, including comprehensive, home-based treatment," said Dr. Dheeraj Raina, addictionologist and Anthem medical director.

To improve the use of counseling with drug therapy, Anthem health plans:

  • Provide access to Bright Heart Health telehealth MAT program to ensure convenient options and have committed to growing this access post-pandemic. About 19-25 percent of those receiving MAT in all of Anthem affiliated health plans began to receive their counseling via telehealth, compared with about 1 percent before the pandemic.
  • Monitor non-fatal overdose metrics to assess real-world impact of holistic strategies, including provider and consumer-based interventions.
  • Encourage primary care providers to become certified in MAT by standardizing reimbursement for these services between primary care and behavioral health providers.
  • Developed bundled payments with practices that encourage treatment for both drug therapy and counseling.
  • Make primary care practices aware of how to bill for early identification and screening for opioid addiction through actively encouraging the use of Screening, Brief Intervention and Referral to Treatment, or SBIRT, codes. Since 2016, Anthem health plans increased use of these codes by 13 times.
  • Support improving the MAT skills of primary care providers via provider contracts with Centerstone, Clean Slate, and Groups Recover Together.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., an independent licensee of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Indiana is available at www.anthem.com. Also, follow us on Twitter @AnthemBCBS_News and @AnthemBCBS or find us on Facebook (News - Alert).


[ Back To TMCnet.com's Homepage ]