Hospital and Physician Update

November – December 2018

A message from Dr. Amy McKenzie
We’re working to increase number of providers able to treat opioid use disorder

Opioid use disorder continues to be a troubling public health concern. The U.S. Department of Health and Human Services estimated that 2.1 million people in the U.S. suffered from OUD in 2016 — and 116 died each day from opioid-related drug overdoses.

That’s why I was gratified to learn that President Donald Trump signed sweeping opioids legislation* into law at the White House in late October. The bill signed includes provisions to expand addiction treatment, speed up research on alternative drugs and provide Medicaid funding to treatment centers. It’s expected to increase access to doctors who can prescribe medications such as buprenorphine that are designed to aid in the treatment of patients fighting addition.

Buprenorphine plays a central role in medication-assisted treatment, a topic my colleague, Dr. William Beecroft, wrote about in the March – April issue of this newsletter. MAT is the use of medications, in combination with counseling and behavioral therapies, to provide a holistic approach to the treatment of substance abuse disorders. Research has shown that a combination of medication and therapy can be very effective in treating these disorders and helping prevent relapses.

One barrier to the widespread use of MAT has been that not enough providers are trained in the use of this approach. It’s also necessary for health care providers who don’t have a subspecialty in addiction medicine to obtain a waiver to prescribe buprenorphine.

To help remedy this situation, Blue Cross Blue Shield of Michigan and Blue Care Network invited eligible providers, including M.D.s and D.O.s, to attend free buprenorphine waiver training in October at several locations across Michigan. The course, offered through the American Society of Addiction Medicine, included four hours of online training and four hours of in-person training.

A total of 74 Blue Cross and BCN health care providers attended the training and became eligible to apply for the waiver. We’re considering offering another training session in the future.

At Blue Cross, we’ve been developing a wide range of tools and strategies to address the opioid epidemic since launching an internal opioid task force last year. A flyer designed early this year highlights many of our efforts. We also launched an Opioids 101 website on MI Blues Perspectives, a source of Blue Cross and Michigan health news for members and others.

Last but not least, we’ve been piloting a medication-assisted treatment incentive program this year for BCN providers. It targets providers who practice in counties that have a high degree of need and a low number of providers who treat opioid use disorder.

The program offers select providers a $1,500 reward for becoming newly waivered. In addition, it rewards all MAT providers $300 for each new patient they accept with a diagnosis of opioid abuse or dependence. The program also rewards both waivered and non-waivered providers $300 for each new patient treated with Vivitrol.

Of approximately 6,000 BCN providers, only about 300 were shown to be waivered to prescribe buprenorphine-containing medications on the Substance Abuse and Mental Health Services Administration website at the start of the pilot.

We’ll be evaluating the program after the pilot concludes Dec. 31, with an eye to developing a similar program for our Blue Cross Blue Shield of Michigan PPO in the future.

Also, as part of our Patient-Centered Medical Home program, we’re looking at how our participating physician organizations can assist practices seeking waivers that will allow them to provide medication-assisted treatment.

To read more

MI Blues Perspectives, one of our two Blue Cross blogs, recently posted a blog about our efforts to increase medication assisted treatment rates for opioid addiction. You can read it by clicking here.

Amy McKenzie, M.D., is Blue Cross’ medical director for Value Partnerships. She’s a family practice physician with 13 years of private practice experience.

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