Highmark Blue Cross Blue Shield West Virginia announced Monday a quality improvement plan aimed at helping West Virginia physicians reduce opioid abuse.
The plan, which includes a partnership with axialHealthcare, aims to help physicians better understand their patients’ total prescription and medication use, and gain insight into their own prescribing patterns in light of the continuing epidemic of opioid misuse and abuse.
“Opioid use has become an issue of national concern,” said Dr. Norman Montalto, medical director for Highmark West Virginia. “While they can be effective in treating acute pain, there is mounting evidence that opioids are less than effective when used for chronic pain — and can actually do more harm than good.”
Montalto said Highmark West Virginia intends to reduce opioid abuse and treat dependency more effectively by giving providers resources and tools that support appropriate prescribing protocols.
Using claims information regularly submitted to Highmark West Virginia, axialHealthcare, a national leader in the appropriate use of opioids for pain management, has developed a Risk Identification and Mitigation (RIM) report that will be generated monthly for providers who have six or more patients using prescribed opioids.
The report gives each provider an individual RIM score that is benchmarked against his/her specialty peer group within the network. Lower scores indicate there is an opportunity to improve compliance with evidence-based standards for prescribing opioids.
This new quality improvement program aims to support Highmark providers by providing more complete patient information at the point of prescribing; increasing awareness of prescribing behaviors and sharing guidelines; and sharing resources and educational tools to support appropriate prescribing protocols.
“We’re excited about being able to provide this critical information to our providers,” said Barb Gray, senior vice president of clinical services for Highmark.
“We know physicians are reliant on what their patients tell them, and those who are suffering from misuse may not communicate the complete picture,” Gray said. “Our expectation is that easy access to best-practice information and visibility to in-network peer performance will help to create a dialogue that leads to safer, more effective care for our shared customers.”
The Highmark Foundation will also host an opioid misuse solutions forum Nov. 9 in Charleston. The purpose of the forum is for key community stakeholders to convene for a fact-based problem-solving discussion around pain treatment and concerning opioid prescription behaviors and the rapidly increasing, material patient health and societal crisis.
Via The Register-Herald.