In the past four years, health plans affiliated with Anthem (NYSE: ANTM) have more than doubled the percentage of members receiving whole-person medication assisted treatment (MAT) for opioid use disorder (OUD).
Four years ago, the insurer found that only 18% of consumers were receiving both drug therapy and counseling services as part of their MAT plan. Instead the vast majority were receiving only medication, with no counseling component to go with it, despite the fact that both the American Society of Addiction Medicine (ASAM) and the Substance Abuse and Mental Health Services Administration (SAMHSA) recommend a combination of both.
“Through our research, we determined there were key barriers to consumers getting the therapy they need – availability of local care providers participating in MAT, appropriate screenings at the primary care provider, and innovative approaches to recovery, including comprehensive, home-based treatment,” Dheeraj Raina, a regional medical director and addictionologist for Anthem, said in a press release announcing the news.
Anthem set out to change that.
It began providing telehealth MAT programs in several markets, standardizing reimbursement for MAT services between primary care and behavioral health providers and developing bundled payments with practices that encourage treatment for both drug therapy and counseling, in addition to introducing other changes.
The goal was to increase access to whole-person MAT for OUD, helping more people receive both drug therapy and counseling. And it worked.
This week, the insurer announced that 36% of members across a total of 26 employer-based, individual and Medicaid plans are now receiving both medication and counseling as part of their MAT for OUD.