This week and in separate press releases, Anthem and OptumRx announced significant improvements through their opioid programs. These successes mark new options for the battle in, what the President declared, the opioid "national emergency". The following are important points from their separate announcements.
For payers, identifying doctors who write more opioid prescriptions can be key for any successful opioid management program. Using the one factor influencing opioid prescription habits, payers can target education improving the overall provider network performance. Physicians trained at the United States’ lowest-ranked medical schools write more opioid prescriptions than physicians trained at the highest-ranked schools, according to a study by Princeton University.
Behavioral health claims skyrocket for any number and combination of factors. Behavioral health care will increase in cost and utilization with a number of factors driving this, including the:
According to the CDC, drug overdoses are the leading cause of accidental death in the United States. Of the overdose deaths that occurred in 2015, 63 percent involved an opioid. Payer options for managing efforts against opioid overuse range from monitoring population data to working with provider networks.
The National Council for Behavioral Health and the National Council Medical Director Institute released a far-reaching report this month: The Psychiatric Shortage: Causes and Solutions. As a recognized leader in behavioral health reviews, this BHM Healthcare Insider Blog brings selections from the executive summary focusing on the behavioral healthcare shortages and solutions.
Managing behavioral health costs challenges the US healthcare system. The issues encompass many of the legacy processes and structures needing to be overhauled. Some interesting recently posted examples may show the way for the entire healthcare system. These come from both payers and providers.
Providers are beginning to bridge the gap between medical and mental care, forming partnerships aimed at improving patients’ physical and mental health, and reducing costs at the same time. Such holistic projects are underway in numerous states, including California, New York, Washington, and Florida.
Athena Health recently published the 2016 edition of Payer View, a in-depth review of the biggest payers in their network. Athena Health identifies the shift to value based care and healthcare reform as the biggest challenges to everyone for payers to providers.
Hospital Readmissions penalties run high as the government plans to penalize more than half of the nation’s hospitals. Over the next year Medicare plans to withhold more than a half a billion dollars in payments, reports Kaiser Health news. In 2015 alone hospital readmissions penalties hit a total of $420 million¹.
Top 5 Pharmacy Trends: Pharmacy Industry Trends and Events2015 has been an extraordinary year for the Pharmacy […]