Horizon Blue Cross Blue Shield of New Jersey announced Wednesday it is part of a national coalition of 16 health companies focused on helping curb opioid abuse.
The move means it will agree to adopt eight “National Principles of Care” that focus on coverage of behavioral health options that have previously been criticized for lack of or limited coverage.
- Universal screening for substance use disorders across medical care settings;
- Personalized diagnosis, assessment and treatment planning;
- Rapid access to appropriate substance use disorder care;
- Engagement in continuing long-term outpatient care with monitoring and adjustments to treatment;
- Concurrent, coordinated care for physical and mental illness;
- Access to fully trained and accredited behavioral health professionals;
- Access to FDA-approved medications;
- Access to non-medical recovery support services.
“Horizon Blue Cross Blue Shield of New Jersey covers 3.8 million lives and, as the state’s largest insurer, we’ve been at the forefront of trying to prevent, detect and treat substance use disorders including opioid abuse. We understand New Jersey because we are New Jersey — we know our members, our providers and our communities — and have built our approach to the opioid crisis around the idea that health care solutions have to exist in the communities where our members live, work and play. That is true whether we are talking about substance use disorders, diabetes or cancer,” said Mary Ann Christopher, Horizon’s vice president of clinical operations and transformation, in a statement. “Horizon is already testing and funding several treatment and support concepts designed to expand the continuum of SUD care, both vertically and horizontally, including community-based peer recovery specialists and community health workers, telehealth solutions and embedded primary care/behavioral health models. These National Principles of Care will be a critical ingredient in evaluating and developing the evidence-based, localized treatment solutions that are the key to turning the tide on this epidemic.”
The Substance Use Disorder Treatment Task Force, launched in April 2017 by Gary Mendell, founder and CEO of Shatterproof, and Dr. Thomas McLellan, founder and chairman of the Treatment Research Institute and former deputy director of the Office of National Drug Control Policy under President Barack Obama, led the effort in developing the system.
“The standard for every major disease in our country is treatment within our health care system using research-based medications and therapies — except addiction,” said Mendell. “For the first time in history, leading health care insurers and other third-party payers from across our nation have come together and agreed to identify, promote and reward one core set of evidence-based principles for addiction treatment. Payers will now begin to establish an accountability process that will systemically change and significantly improve the way that treatment for addiction is delivered in our country.”
This news comes soon after President Donald Trump’s declaration of the opioid crisis as a public health emergency, rather than a national emergency, which received criticism for missing the mark and not providing funding that providers were anxious to obtain.
Trump’s strategy includes:
- Funding the crisis with roughly $56,000;
- An advertising campaign;
- Targeting youth in drug-free education;
- The war on drugs at the southern border;
- USPS scanning for Chinese drug parcels;
- Access to overdose reversal medications like Narcan/Naloxone.
Most of these efforts are already under way, or have been for some time, and some have proven ineffective.
But some experts said there is a silver lining, which is the attention being paid to the issue.
“We have to pause and recognize the attention the president has paid to the issue,” said James Curtin, president of Daytop New Jersey. “I think the president has to be applauded for that. For his work and his commitment. We hope and we pray we are going to see action.”
Jim Cleary, a professor of oncology and palliative care at the University of Wisconsin and director of the Pain & Policy Studies Group, said a lack of real understanding is part of the problem.
“We need to be taught how to discern data appropriately,” he said. “I don’t think we truly understand what is going on with the opioid epidemic in the United States.”