Opioid use plummets for Michigan's Priority Health population

(Grand Rapids, Mich. - Apr. 23, 2019): Michigan-based health insurer Priority Health recorded a dramatic decrease in opioid use among the company's membership across all business lines, a positive step forward in the ongoing opioid epidemic sweeping through the state and across the county.

Since 2017 when Michigan set a new record for opioid-related deaths, legislators and healthcare organizations have worked to reduce the use and abuse of opioids in the state. Recognizing the problem early on, Priority Health was one of the first health plans in the state to deploy an aggressive, targeted strategy to try and reduce opioid overdose. Launched in November of 2017, the Priority Health program focused on increasing awareness, making "rescue" medicine like Naloxone more available and improving access to Medication Assisted Treatments and behavioral health services.

After one full year of data was collected and analyzed, Priority Health has seen use of opioids by its members significantly decline, specifically:

  • Commercial members: 47% reduction
  • Medicaid members: 36% reduction
  • Medicare members: 18% reduction
"We can't reverse the opioid epidemic until we reduce entry into opioid use, improve and promote access to non-opioid alternatives for chronic pain and ensure that opioids are taken by people who really need them, not those who don't," said Dr. James Forshee, Senior Vice President, Chief Medical Officer at Priority Health. "We are excited to see how much change has happened in a short amount of time, but there is much more to be done, and we are looking at how we can continue to build on the progress we've made."

Priority Health's opioid strategy included the following steps to help protect members:

  • Improving access to behavioral health services
  • Limiting the number of short-acting opioids for acute pain to a 15-day fill
  • Limiting the number of long-acting opioids for chronic pain to a 30-day fill
  • Reducing the maximum daily dose to 120 MEqD (morphine equivalent dose)
  • Reducing the number of members receiving prescriptions from multiple doctors

"While we follow evidence-based recommendations to help our population, our approach considers how social determinants of health may impact medical outcomes, ensuring the member's care plan includes the full range of services required for them to get healthy and stay healthy," Forshee said.

Opioids are a class of drugs used to reduce pain. This drug class includes the synthetic pain reliever Fentanyl, typically used for treating advanced cancer, and heroin, an illegal opioid. It also includes commonly prescribed drugs that effectively treat moderate to severe pain but that come with serious risks and side effects including the possibility of death by overdose. Some of the most commonly prescribed opioids include Oxycodone, Vicodin and Morphine. The Centers for Disease Control reports that every day, more than 130 people in the U.S. die after overdosing on opioids.

While Priority Health saw a decreased usage within its membership population in early 2018, the company recognizes that other stakeholders, such as Michigan lawmakers, have played a role in helping further reduce usage. Enacted in mid-2018, the Michigan Opioid Laws package contains various rules which have helped to curb opioid abuse, including parental consent for minors to receive opioids, limiting doctors from prescribing more than a seven-day supply for patients in acute pain and prescribers providing information on how to properly dispose of an expired, unused, or unwanted controlled substance.

Another resource in the fight is behavioral health specialists. Priority Health's trained behavioral health team members talk to patients, assess their needs and help them determine substance abuse treatment and/or medical management options. This includes an inpatient detox program, a short-term, intensive residential treatment program and outpatient behavioral health therapy and medical management. If a Priority Health member has concerns about opioid dependency, or substance overuse or misuse, they are recommended to call 1.800.673.8043.

About Priority Health:

Priority Health is an award-winning, Michigan-based non-profit health plan nationally recognized for improving the health and lives of the people it serves. It continues to lead the industry in engaging members in their health, delivering effective health and disease management programs and working with physicians to improve health care outcomes and performance. Priority Health is one of only 20 health plans nationwide offering wellness programs accredited by the National Committee for Quality Assurance, an organization which also rated it among the best health plans in the nation. The State of Michigan named the Priority Health HMO the benchmark plan for all individual and group HMO plans to model.

Priority Health offers a broad portfolio of health benefit options for employer groups and individuals, including Medicare and Medicaid plans. Its network of health care providers features 95 percent of practicing physicians available in Michigan and more than 900,000 health care providers nationwide.