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Home   ›   Beyond Managed Care   ›   Opioid Outreach and Treatment
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Opioid Outreach and Treatment

Joanne McFall, Market President for AmeriHealth Caritas’ southeastern Pennsylvania health plan, Keystone First, talks about how our collaboration with CleanSlate helps us target and address the opioid crisis right here in our own backyard — and in other communities to come.

As the human and financial toll of opioid addiction continues to rise, we are committed to fighting this epidemic through a combination of outreach, prevention, and treatment programs. We not only want to understand the underlying causes of opioid abuse, but also treat those who are already addicted and prevent new addictions.

  • The Opioid Crisis: Protecting Medicaid Members

    How AmeriHealth Caritas is helping

    Our multifaceted Opioid Blueprint (PDF) tackles opioid addiction from a whole-person perspective, treating not only the physical symptoms but the behavioral and social ones as well. We work with pharmacies, providers, and members to address all the factors of opioid addiction.

Members

With the help of our providers and through our outreach campaigns, we educate our members about the risks of opioid use and urge them to:

  • Properly store and lock medications and not leave prescriptions in easy-to-access areas. Seventy-five percent of young people who have abused prescription pain medicines have gotten them from a family member or a friend.1
  • Get rid of medicines that are no longer needed. Keep track of what’s left and be aware if it goes missing.
  • Learn the risk factors for drug abuse.2 They can include a family history of addiction, a family history of mental health issues, and peer pressure, especially among children.
  • Join one of our opioid addiction treatment care management programs, if needed. Through a combination of counseling and medication-assisted treatment (MAT), these programs provide personal, specialized care that helps to destigmatize addiction and offers physical and mental support.

Pharmacies

As a frequent point of contact between patients and other providers, pharmacists have a unique role in identifying and preventing opioid misuse. We work with pharmacists to:

  • Implement prescribing limits (for both supply and dosage) on opioid medications as recommended by the Centers for Disease Control and Prevention and our state partners.
  • Use analytics to detect any inappropriate prescribing or usage patterns.
  • Identify members receiving opioids from multiple prescribers and refer them to treatment as needed.

Providers

Because providers treat patients and prescribe medications, they play a crucial part in talking to their patients about the dangers of opioids, prescribing responsibly, and identifying abuse. We encourage them to:

  • Consider alternative pain treatment options. Opioid drugs should not be the default treatment. Discuss all possible treatment options and their benefits and risks with patients.
  • Prescribe opioids at the lowest effective dosage when they’re absolutely necessary.
  • Meet with patients again within one to four weeks of prescribing opioids. When treatment is complete, reduce or taper dosages, or discontinue them altogether.

MAT

One of the key treatment methods, MAT is an evidence-based approach that uses Food and Drug Administration (FDA)-approved medications, like buprenorphine, methadone, and naltrexone microspheres, to treat opioid use disorder.

While only one component of successful treatment programs — counseling and community supports need to be included as well — MAT is instrumental in helping us address opioid use disorder.

We’ve seen a 26 percent decline in opioid use among our members and a 12 percent increase in the use of MAT. Just as impressively, MAT can provide a cost-effective option for your state. Members who used MAT had a 32 percent lower cost of treatment than those who didn’t.

Additional outreach programs

Despite our best efforts, we can't combat opioids alone. That’s why we’ve partnered with other local behavioral organizations to deliver additional outreach programs. For example, in Pennsylvania, these efforts include:

  • PEARL (Prevention, Education, Addiction, Recovery and Linkage), a program with Crozer-Keystone Health System, which helps both expectant mothers with addiction and their unborn children. 
  • CleanSlate, an award-winning, medication-assisted treatment facility with multiple locations.

For more on our Opioid Blueprint and out treatment efforts, download The Opioid Crisis: Protecting Medicaid Members (PDF).

  1. “Prescription Drug Abuse Among Teens: Survey,” WebMD, April 23, 2013, https://www.webmd.com/parenting/news/20130423/prescription-drug-abuse-up-among-us-teens-survey#1.
  2. Commonwealth Prevention Alliance, “PA Stop Campaign Goes National,” November 2, 2017, https://commonwealthpreventionalliance.org/pa-stop-campaign-goes-national/.

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