Saturday, June 16, 2018

WellCare says it reduced opioid dispensing 55% among 1,300 Kentucky Medicaid members targeted due to risk for addiction

WellCare Health Plans, one of the insurance companies that manages care for Medicaid patients in Kentucky, says it cut opioid prescriptions among a targeted group of Kentucky members by more than half.

Bill Jones, president of WellCare of Kentucky, wrote in an op-ed for newspapers, "WellCare identified 1,300 members who, based on their refill patterns and other factors, appeared to be at risk for developing an opioid addiction. These members were connected to one pharmacy, one physician and one care manager — a team approach in which everyone on the team was aware of the entire case history. The result: opioid dispensing dropped by 55 percent."

Jones added, "This kind of innovative approach is successful because it addresses opioid abuse at the root, helping people – many of whom are living with pain – find a healthy path forward that works to lower the risk of opioid addiction."

WellCare says it has taken other steps to fight the problem. Jones said the company donated $35,000 to support addiction recovery programs in the state, most of it to Addiction Recovery Care, which operates seven residential facilities in Eastern Kentucky.

"In Illinois, WellCare has implemented programs to encourage doctors to refer members to substance abuse treatment if they are at-risk for addiction – and to encourage members to keep follow-up appointments," Jones wrote. "In another intervention program, WellCare helped educate Medicare members on alternative treatments, conducted proactive outreach out to prescribers and connected members to WellCare’s behavioral health case management teams for support. As a result, between 2015 and 2017 opioid utilization dropped by 43 percent."

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