Highmark WV program to reduce opioid abuse

PARKERSBURG, W.Va. (Oct. 31, 2016) – Highmark Blue Cross Blue Shield West Virginia announced today that it has joined forces with axialHealthcare, a national leader in the appropriate use of opioids for pain management. Together they will help West Virginia 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. 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,” said Norman Montalto, D.O., medical director for Highmark West Virginia. “By working in conjunction with our providers and axialHealthcare, 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 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. We know physicians are reliant on what their patients tell them, and those who are suffering from misuse may not communicate the complete picture,” said Barb Gray, senior vice president of clinical services for Highmark. “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.”

“We are pleased to partner with Highmark and begin offering our unique pain care capabilities to support physicians and patients while reducing opioid misuse. Highmark and axialHealthcare are committed to improving care for patients in pain throughout West Virginia.” said axial Chairman and CEO John J. Donahue

To further demonstrate Highmark West Virginia’s commitment to increasing member safety and to delivering care management programs that help address the clinical, behavioral and societal realities that providers deal with every day, the Highmark Foundation will host an opioid misuse solutions forum in Charleston, on Nov. 9, 2016. 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.

About Highmark Blue Cross Blue Shield West Virginia
Highmark Blue Cross Blue Shield West Virginia serves approximately 290,000 members through the company’s health care benefits business and hundreds of thousands of additional members through the Blue Card program. With offices in in Parkersburg, Charleston and Wheeling, it employs more than 750 people. Highmark West Virginia is an independent licensee of the Blue Cross and Blue Shield Association. For more information, visit www.highmark.com.


Via West Virginia Press.

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