Nationally, Medicaid members are more than twice as likely to receive opioid prescriptions as non-Medicaid members and at a higher risk of opioid-related death.
CareSource stated that in 2016 it started a program to notify providers who are prescribing high amounts of opioids to members.
“We know that helping members get on a path to recovery and self-sufficiency leads to better outcomes,” stated Jonas Thom, vice president of behavioral health at CareSource.
Using claims data, CareSource can identify members at risk for substance use disorder, diversion, overdose and alert providers.
CareSource analyzed the number of pills, dosing schedules and strength of what was being prescribed to its policy holders.
CareSource also sends letters to prescribers showing how their prescribing compares to their peers.
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CareSource also highlighted other efforts like transportation to recovery services, decreased long-term opioid prescriptions and case management to address other barriers like child care and employment.
CareSource stated this year it will also begin monitoring teenagers and young adults for opioid risk.
“We have certainly had a meaningful impact on our members’ lives and the opioid crisis through our targeted programs, but there is more to be done,” Thom stated.