Opioid Use is Growing at an Unprecedented Rate
The Substance Abuse and Mental Health Services Administration reports that in 2016, 11.5 million people misused prescription opioids and 2.1 million had an opioid use disorder. In 2017, the number of overdose deaths involving opioids was five times higher than in 1999.
Our country’s uncoordinated system of care compounds existing issues, such as the ability to quickly and effectively identify at-risk individuals, access to evidence-based treatment, timely care transitions, and linkage to community supports. With a lack of outpatient resources, the current delivery system also puts undue emphasis on avoidable inpatient care.
- The economic burden of the opioid epidemic is $78 billion annually; treatment costs account for $29 billion.
- Because many clinical treatments do not align with the evidence base, less than 10 percent of people with OUD receive evidence-based medication-assisted treatment (MAT).
Increasing Access to Evidence-Based Treatment
To combat the growing OUD crisis, Beacon is redesigning systems of care to develop a more seamless treatment pathway from acute care to long-term, community-based rehabilitation.
Our comprehensive OUD program engages high-risk members in care management, promotes the use of evidence-based treatment, increases provider and community capacity to support people with OUD, and ensures access to high-quality, more efficient care:
- Identifying at-risk members to apply early interventions. Using advanced analytics that combine behavioral, medical, and pharmacy data, we identify high- or at-risk individuals who need immediate intervention to prevent overdose or acute-care episodes. We also analyze pharmacy data to reduce unusual prescribing practices and increase medication adherence.
- Improving service engagement and retention. Through our specialized case management interventions, technology-enabled treatment solutions, and real-time clinical and peer recovery supports, we help members stay engaged in best-practice care. This way, we fill gaps in care and make important linkages to community supports and services to stabilize members during critical care transitions.
- Increasing access to community-based care. Beacon builds an end-to-end OUD treatment network, including high-performing providers and facilities, across all levels of care. We also use value-based payment models to expand our specialty MAT network, improve network performance, and incentivize improved access and adherence to MAT.
MAT Improves Clinical Outcomes
Beacon has established a value-based payment program with an outpatient MAT provider offering a full continuum of support services. Results from the first 200 members enrolled indicate an 85% treatment engagement rate at 90 days while only 5% admitted to inpatient substance use disorder treatment, representing a 28% decrease compared to members not enrolled in the program.
- MAT leads to improved clinical outcomes with 50-60% reduced costs.
- Beacon’s community-based case management programs have reduced cost of care for high utilizers by 10-30%.