Concrete actions for payers and purchasers seeking to effectively manage opioid utilization. Key resources include a minimum insurance benefit design for patients with opioid use disorder and case studies of health plans that have successfully incorporated interventions to encourage safe and appropriate opioid use. Hover the cursor over the text to see a description of the resource.
Utilization Management
- Health Plan Rx for the Opioid Epidemic (California Health Care Foundation [CHCF])
- Stemming The Tide of Prescription Opioid Overuse, Misuse, And Abuse (Health Affairs blog)
- An Action Guide for Management of Opioid Dependence: Next Steps for Payers and Policymakers (Institute for Clinical and Economic Review [ICER])
- Ensuring Safe and Appropriate Prescription Painkiller Use: The Important Role of Community Health Plans (Alliance of Community Health Plans)
Utilization Management and Benefit Design
- Reducing Opioid-Related Morbidity and Mortality: Payer and Provider Strategies (Smart Care California)
- Curbing the Opioid Epidemic: Checklist for Health Plans and Purchasers, updated November 2017 (Smart Care California)
- Insurance Barriers to Accessing Treatment of Opioid Use Disorders (California Society of Addiction Medicine)
- Minimum Insurance Benefits for Patients with Opioid Use Disorder (California Society of Addiction Medicine)
- Changing Course: The Role of Health Plans in Curbing the Opioid Epidemic (CHCF)
- Case Studies: Three California Health Plans Take Action Against Opioid Overuse (CHCF)
- Managing Pain Safely: Multiple Interventions to Dramatically Reduce Opioid Overuse (Partnership Health Plan of California)
- Prescription Opioid Abuse: Challenges and Opportunities for Payers (National Center for Biotechnology Information)
- CMCS Informational Bulletin: Best Practices for Addressing Prescription Opioid Overdoses, Misuse and Addiction (Centers for Medicare & Medicaid Services [CMS])