Opioids

Removing Prior Authorizations Had Mixed Effect On OUD Care Uptake

June 27, 2022 - Beneficiaries may face barriers to substance abuse care when states impose prior authorizations for substance use disorder treatments, but a broad range of policies can influence Medicaid beneficiaries’ access to care, according to a study published in JAMA Health Forum. Buprenorphine is a prescribed medication-assisted treatment for...

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AHIP Responds to Proposed CDC Opioid Prescribing Guidelines

by Kelsey Waddill

AHIP has responded to the latest updates to opioid prescribing guidelines from the Centers for Disease Control and Prevention (CDC). CDC’s proposed updates to the opioid prescribing guidelines...

Low Value Care Spending on Low Back Pain Is Decreasing

by Kelsey Waddill

The healthcare industry is making strides in diminishing low value care spending for commercially-insured patients with chronic low back pain (LBP), according to a research letter published in JAMA...

Payers Lag On Acupuncture Coverage Despite Rising Utilization

by Kelsey Waddill

Although acupuncture utilization has grown in recent years, only half of acupuncture visits had any form of coverage in 2019, according to a research letter published in JAMA Network Open. The...

How Medicaid Enrollment Assistance Supports Incarcerated Persons

by Kelsey Waddill

Prerelease Medicaid enrollment assistance for incarcerated individuals who have substance use disorders can help improve outpatient utilization after release, a study published in JAMA Open Network...

NCQA Releases Health Plan Performance Ratings with COVID-19 Data

by Kelsey Waddill

The National Committee for Quality Assurance (NCQA) has released its first set of Health Plan Ratings since 2019, providing insight into health plan performance during the coronavirus...

Payer Announces Partnership to Address Opioid Misuse, Disposal

by Victoria Bailey

CareSource has announced a partnership with a medication disposal solution to help members avoid accidental poisoning and opioid misuse. The solution is a powder that disables the active ingredients...

CMS 2022 Final Rule Requires Part D Real-Time Drug Benefits Tool

by Kelsey Waddill

CMS has released its final rule for Contract Year 2022 Medicare Advantage and Part D which requires Part D plans to offer a real-time benefits comparison tool. The agency estimated that the...

Highmark Expands Partnership to Personalize Substance Abuse Care

by Kelsey Waddill

Highmark Inc. (Highmark) has expanded its partnership with an end-to-end substance abuse care vendor, axialHealthcare, to better serve members in Pennsylvania with substance abuse care...

Payer Empowers Grassroots Movement to Tackle Opioids Epidemic

by Kelsey Waddill

While payers are pursuing high quality substance abuse care for their members, supporting employees through substance abuse and reducing stigmas around the opioids epidemic is equally critical,...

National Hepatitis C Screening Rate Low Despite Widespread Need

by Kelsey Waddill

The U.S. Preventive Services Task Force (USPSTF) has made a B-level recommendation that all young adults and adolescents should be screened for hepatitis C, which has become more prevalent in the wake...

Implementing Value-Based Reimbursement in Behavioral Healthcare

by Kelsey Waddill

Residents of western New York will have access to the region’s first behavioral healthcare provider group with a value-based reimbursement arrangement, BlueCross BlueShield of Western New York...

How Peer Recovery Increases Medication Adherence, Lowers Spending

by Kelsey Waddill

Update 02/21/2020: This article has been updated to reflect that Blue Cross Blue Shield of Rhode Island partnered with the Anchor Recovery Community Center (a program of The Providence Center) to...

VA Medicaid Program Reduces ED Admissions for Opioid Use Disorder

by Samantha McGrail

After the implementation of Virginia’s Medicaid program, Addiction and Recovery Treatment Services (ARTS), emergency department (ED) visit declined by 21.1 percent among beneficiaries with opioid...

How State Budgets Impact Medicaid Funding, Reveal Priorities

by Kelsey Waddill

As January comes to a close, some states are determining their Medicaid funding streams for the new fiscal year. Obstacles to passing state budgets illuminate states’ competing priorities when it...

Finalized CMS Rule Supports Medicare Coverage for Acupuncture

by Samantha McGrail

CMS has finalized a proposed rule to provide Medicare coverage to chronic low back patients accessing acupuncture, which furthers the administration’s efforts to address the opioid...

Best Practices to Address Opioid Use Disorder for Medicaid Directors

by Emily Sokol, MPH

The overdose death rate from prescription opioids rose by 12 percent from 2016 to 2017, urging states to address opioid use disorders. As the opioid epidemic shows no signs of slowing, healthcare...

Challenges of Creating Medicare Advantage Supplemental Benefits

by Kelsey Waddill

Medicare Advantage plans are slow in creating benefits that serve more than medical needs for severely ill members, potentially because designing and implementing a new healthcare benefit is...

Strategies for Addressing Opioid Use Disorder in Rural Areas

by Emily Sokol, MPH

The opioid epidemic has affected rural and urban areas alike. According to research from the American Academy of Family Physicians, those in rural areas had an 87 percent higher chance of receiving an...

CMS OKs Demo to Expand Behavioral Health Treatment in Medicaid

by Samantha McGrail

CMS approved a Section 1115 demonstration that will broaden behavioral health treatment for Medicaid beneficiaries living in the District of Columbia who have been diagnosed with serious mental illness...

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