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Blue Cross Blue Shield of Michigan Takes a Stand Against the Opioid Crisis

May 7, 2019
A National Safety Council survey revealed that more than 70% of workplaces are negatively affected by opioid abuse. In fact, nearly 40% of employers said employees miss work due to abuse of painkillers, with roughly the same percent reporting employee abuse of these drugs while on the job.

Michigan is especially hard hit by this crisis, ranking 10th nationally for highest rates of prescribing opioids and 18th for most overdose deaths.

The Detroit Regional Chamber recently interviewed Blue Cross Blue Shield of Michigan (BCBSM) to learn what the organization is doing on the provider side to mitigate the crisis and help those suffering from opioid abuse or addiction. Together with doctors, pharmacies, community organizations, policy makers, public health advocates, foundations, and employers, BCBSM has developed a comprehensive strategy that includes prevention, treatment, and awareness.

Prevention – Prescription Restrictions

To ensure the safe and appropriate use of medications, BCBSM targets highly abused opioids with tools including prior authorization, refill restrictions, and quantity limits to help prevent stockpiling and excessive quantities of pain pills. Members starting opioid therapy and receiving a short-acting opioid have the first fill limited to a five-day supply.

BCBSM also identifies at-risk members by monitoring claims to prevent them from receiving a dangerous and highly addictive drug combination commonly referred to as the “Triple Threat.” This combination includes opioids, benzodiazepines, and Soma® taken together. Since 2014, the number of BCBSM members receiving the dangerous “Triple Threat” drug combination has decreased by 93% and approximately 900,000 fewer opioid pills have been dispensed.

Treatment – CLIMB Pilot Program

BCBSM’s controlled substance workgroup of doctors, behavioral health specialists, case managers, pharmacists, and corporate investigators reviews pharmacy and medical claims reflecting potential opioid misuse or abuse to coordinate treatment referrals and ongoing care management. Their Community-based Life-changing Individualized Medically-assisted evidence-based treatment program (CLIMB) uses innovative approaches such as sober coaching, in-home treatment, and an online mobile app to help improve treatment adherence, increase use of medication-assisted treatment, and minimize relapse.

Awareness – Public Education

BCBSM has made significant efforts to educate and inform the public about how to get rid of unnecessary medications, including sponsoring drug take bake kiosks at certain Walgreens locations. BCBSM and the Michigan Opioid Prescribing Engagement Network (M-OPEN) work with physician groups to improve statewide prescribing practices and utilization. M-OPEN works with doctors and hospitals to decrease new opioid prescriptions to surgical patients and raise awareness of the dangers of opioids.

From 2012 through 2018, they have seen encouraging results:

  • 44% reduction in opioid prescriptions
  • 49% reduction in the number of opioid pills dispensed
  • 65% reduction in fentanyl products dispensed
  • 72% reduction in long-acting oxycodone and oxymorphone use

Work With Your Health Care Provider

To do their own part in ending the crisis, BCBSM has recommended that employers take the following steps:

  • Help employees access treatment. Employers can ensure their workforce has access to quality treatment for substance addiction. Group customers can work with their BCBSM sales representative to discuss a comprehensive option that covers inpatient and outpatient services. Employees with opioid addiction can often benefit from medication-assisted treatment, which reduces the cravings for opioids and allows employees to work while in treatment.
  • Create a nonstigmatizing workplace. One way to influence more people to seek help is to convince them that getting treatment is the smartest thing to do. By talking about addiction like any other disease, employers can silence the stigma and let employees know it’s okay to ask for help. It’s equally critical for owners and managers to send messaging emphasizing the workplace as a safe place.
  • Equip staff to recognize the signs of addiction. It’s important management and staff be trained on the early signs of opioid and substance addiction so they can intervene before the situation deteriorates. Train managers to address performance issues in a way that encourages open and honest dialogue to talk about sensitive matters.
  • Offer support to employees and family members. Just as co-workers would with an employee who has a medical condition, such as cancer or heart disease, offer nonjudgmental support to employees with a substance use disorder. Remember, employees who have family members struggling with substance addiction suffer at work too. Those who are affected by a loved one’s addiction can have increased absenteeism, lack of focus, and health problems related to stress.