Healthcare organizations develop joint road map to combat opioid crisis

A coalition of companies spanning the healthcare industry have developed a strategy for combating the opioid crisis that they claim offers a more comprehensive public health approach than previous efforts.

The Healthcare Leadership Council, which includes executives from hospitals, drugmakers, insurers, employers and patient advocates, on Wednesday released their "Roadmap for Action," which highlights moves healthcare providers, lawmakers and regulators can take toward reducing opioid misuse, addiction and overdose while improving patient care.

The road map calls on healthcare providers to improve their approach to pain management; improve their opioid misuse prevention efforts; expand access to substance use disorder treatment services; and use data more to improve care coordination.

The group recommended lawmakers and regulators develop better payment models to encourage clinicians to provide substance use disorder treatment, since access to these treatments is limited in many areas.

Approximately 50,000 of the more than 900,000 physicians active in the U.S. are certified to prescribe the medication-assisted treatment drug buprenorphine. Access to methadone remains highly regulated and limited to just more than 1,400 clinics, according to the U.S. Substance Abuse and Mental Health Services Administration. That's an increase of about 300 clinics since 2003.

Mary Grealy, president of the Healthcare Leadership Council, said providers and the government should form more public-private partnerships and encourage technology and data solution development to better distribute treatment resources to underserved areas.

"It really is a call that this really has to be a public-private partnership, and that we're [healthcare] willing to take a leadership role in this," Grealy said.

In terms of prevention, Grealy called on healthcare providers to adopt electronic prescribing for all controlled substances by 2020. Congress is considering a limited version of that recommendation in the Every Prescription Conveyed Securely Act, which would require e-prescribing of controlled substances under Medicare Part D by 2020.

"Electronic prescribing would make it far easier for surgeons to write smaller prescriptions that meet the needs of 80% of patients, or even 50%, knowing they could remotely order an additional supply if a patient needed it," wrote Dr. Atul Gawande, a surgeon at Brigham and Women's Hospital, in an article published in 2017 in the Annals of Surgery in support of adopting e-prescribing. Gawande was recently named CEO for the new Amazon, JPMorgan Chase and Berkshire Hathaway healthcare venture.

Congress has already passed several bills that fall in line with the road map, but there is still work to be done. Grealy stressed that lawmakers need to amend confidentiality regulations to align with HIPAA's Privacy Rule, which allows for patients' information to be shared without consent for the purpose of treatment and payment. On Wednesday, the House passed the Overdose Prevention and Patient Safety Act, which would eliminate current restrictions on patient information sharing between healthcare organizations. Some addiction treatment advocates have argued those restrictions have hindered efforts to better coordinate substance use disorder treatment.

Other technology-related recommendations advocated by the coalition included calling for greater use of pharmacogenetic testing to assess an individual's risk for opioid misuse, and for the creation of an Opioid Learning Action Network where healthcare leaders could share best practices and develop innovative care models.

The road map is based on recommendations that came out of a workshop HLC held in May in Washington D.C.

"We believe we need a national solution that allows us caring for consumers to see whether they've been prescribed opioids in the past or have a history of addiction," said Erin Hoeflinger, senior vice president and president of commercial local business for health giant Anthem, which took part in developing the road map.