Health plans can take steps to counter costly opioid epidemic, researcher says

Insurers need to use a multipronged approach to create well-designed health insurance plans and counter the steep costs of opioid misuse, according to an article by the director of the Center for Health Services Research in Georgia State University's J. Mack Robinson College of Business.

The article by William S. Custer, director of the Center for Health Services Research, appears in the Journal of Financial Service Professionals.

To design effective plans, he said, insurers can identify appropriate care or prevention strategies, define at-risk populations and focus on provider payment and patient education strategies.

The opioid epidemic has been a challenge for insurance plans because it has negatively affected both patient health outcomes and cost of care. Previous research shows that diagnosed opioid abusers have an average annual, per-patient health care cost of more than $11,000 above the average enrollee. But there are steps health plans can take to manage costs and adverse health outcomes resulting from opioid misuse, Custer said.

Plans can use precise metrics that address pain management and opioid abuse to better tie health care providers' reimbursement to quality metrics, he said. Health plans can help patients understand the risks of opioid use and address the needs of those who have become dependent on the drugs. These strategies can be enhanced through use of data that can identify population needs and individual risk factors.

"The economic burden of opioid abuse exceeds $78 billion," Custer said. "There needs to be a systematic approach to pain management that reduces both the number of people living with chronic pain and the consequences of opioid abuse."