Ohio Insurers Issue Opioid Recommendations

Jun 13, 2018

Miranda Motter speaks with reporters
Credit Ohio Public Radio

A task force of health insurers convened by the Ohio Attorney General's office has released 15 recommendations on how they can help with the opioid crisis. 

The recommendations include proposals on prevention, intervention and treatment . Ohio Public Radio's Karen Kasler reports. 

The list of recommendations from eight of Ohio’s health insurers includes proposals on prevention, intervention and treatment of opioid addiction – such as developing education programs, assigning care managers to patients, covering non-drug alternative therapies like massage, and other proposals.  Bruce Hill is the president and CEO of Buckeye Health Plan, the state’s second largest insurer.

“The addiction and pregnancy program – we were able to walk with her to work through a care plan in which she now is clean, she has two healthy kids.”

Miranda Motter is president and CEO of the Ohio Association of Health Plans, and she says insurers are already doing many of these recommendations in the group’s report, such as….

“Looking at prescribing guidelines and making sure that those, as doctors are prescribing, they’re doing in accordance with uniform guidelines.

Other proposals include programs to reduce “doctor shopping” and using multi-disciplinary teams to coordinate care.  Mario San Bartolome, the medical director for substance abuse disorders for Molina Healthcare, says that’s important because two-thirds of the population his health plan covers have been abused as children.

“You can almost predict the likelihood, statistically, of not only a substance use disorder but death from a cardiovascular disorder because it all overlaps just from how many adverse childhood events you might have had.”

Other insurers involved include the state’s largest, Medical Mutual, along with Aetna, Anthem, CareSource, Paramount, and United Healthcare. Attorney General Mike DeWine convened this task force last year.

“Insurance companies, sometimes much to our chagrin as patients, control a lot of our life. So what the idea behind this is, let’s use them for good. Let’s use them to figure out how to have fewer people become addicted.”

Some of the proposals could be expensive for health plans covering Medicaid recipients, who are twice as likely to receive opioid prescriptions as those not on Medicaid.  But San Bartolome says not dealing with these issues could be more costly in the long run because the people covered by Molina represent a disproportionate number of those who experience and sometimes die of opioid overdoses.

“These people with this disease matter just like anybody else with cancer, diabetes, hypertension. And it actually makes financial sense to take care of this in comprehensive, integrated type of approach.”

While the health plans involved in the AG’s task force say they’re putting the recommendations into action, they aren’t mandates. DeWine is the Republican nominee for governor, and while he didn’t say he’d push for them to be put into law, he did say he’s prepared to call out insurers that don’t incorporate them.