Despite a decrease in opioid prescribing, there were X opioid overdose deaths in 2017. A recent industry study estimated that the total added costs to the healthcare system for patients who overdose on opioids was $11.3 billion annually, with $7.4 billion of the expense shouldered by Medicaid and Medicare programs. The study focused on 100,000 opioid overdose patients with nearly 430,000 total visits across emergency department, inpatient and other care settings. Sixty-six percent of the patients were insured by Medicare or Medicaid, and 16% used a commercial health plan.
A recent analysis for one of our health plan clients confirms the high costs. We found that 1% of the client’s highest risk members on opioids were driving an average of $3,900 in monthly spend per member.
Perhaps high spend for patients who overdose is unsurprising, but the study also highlights the 4+ touches with healthcare providers for each patient who overdosed—all of which offer a chance to intervene and change the care trajectory for that patient.
For the client mentioned above, implementing a program to identify and intervene for these highest risk, highest spend members has an immediate impact on clinical and financial outcomes. axialHealthcare’s program:
- Informs the primary care or pain management provider when visits to the ED, inpatient stays, and opioid overdoses occur.
- Facilitates screening for opioid use disorder, because the first step to treatment is a diagnosis.
- Takes a feet-on-the-street approach to opting members into medication-assisted treatment (MAT) when diagnosed with OUD.
- Identifies supply and demand gaps for MAT to build out the network.
If you want to understand the impact of opioid abuse and misuse on your population, let’s find some time for a call. I would love the opportunity to explore a custom solution that improves care and outcomes for your members.