Can health insurers play a role in recovery from addiction?

Richard Snyder, M.D., chief medical officer for Independence Blue Cross, says there’s no doubt insurers can play an integral role in addiction prevention and recovery.

When it comes to the nation’s opioid addiction and overdose crisis, Dr. Richard Snyder, senior vice president and chief medical officer of Philadelphia-based Independence Blue Cross, says “Our strategy starts with prevention.”

Snyder says Independence has programs in place to limit opioid prescribing when appropriate, curb “doctor shopping” (when patients seek opioids from multiple doctors and pharmacies to avoid detection of prescription misuse), and educate doctors who may be prescribing more narcotic painkillers than necessary. And that’s just a start when it comes to the insurer’s efforts to fight opioid misuse. Other insurers have adopted similar practices; Independence’s program is particularly comprehensive, addressing everything from prescribing practices to evidence-based treatment.

And it has to be, Snyder says. In Philadelphia and its environs, many people are already addicted or have died due to opioids. Snyder says that in 2016 there were more than 900 deaths from overdose in Philadelphia. And in the five surrounding counties Independence Blue Cross serves, there were 1,650 overdose deaths in 2016, a 30 percent increase over the prior year, according to the Philadelphia Department of Public Health.

That’s why, Snyder says, he sees detox and medication-assisted treatment as integral pieces of the treatment options for patients who are ready to begin their recovery from opioid use disorder.

But the chief medical officer says there’s much more to recovery than medication to ease cravings and stave off withdrawal.

“It’s simply not adequate to be prescribed buprenorphine (a medication that helps reduce cravings for opioids),” says Snyder. “It needs to be accompanied by therapy,” to help a patient get at the underlying issues that contributed to their addiction. Snyder says Independence’s behavioral health case managers reach out to patients to help connect them to therapy.

And then, Snyder says, the insurer helps patients tackle one of the most likely reasons they were introduced to opioids in the first place: chronic pain. Patients are referred to pain management specialists who can prescribe non-opioid painkillers, physical therapy and other kinds of treatment. Snyder says the insurer is considering covering more alternative therapies for chronic pain, such as acupuncture.