Collaborating to Reduce Opioid Abuse

Nov. 20, 2019

At Blue Cross and Blue Shield of Montana we pledge "to do everything in our power to stand with our members in sickness and health". We take that very seriously. That is why we have started a new program to help you care for members who may be at risk for an opioid-related adverse event. We hope that by collaborating with members and providers, we can find ways to reduce risk and promote patient safety.

BCBSMT now scans pharmacy and medical claims to identify members with a combination of the following risk factors:

  • High morphine equivalent daily dosing (MED)1
  • Dangerous drug combinations (i.e., opioids, benzodiazepines, muscle relaxers)
  • Receiving controlled substance prescriptions from multiple providers.

When warranted, we reach out to members and providers to inform them of the potential risks. We also provide support to reduce that risk. Support can include ensuring members have access to Narcan (naloxone) and are aware of how to use it. We can also offer non-opioid alternatives such as physical therapy and cognitive behavioral therapy. This initiative is one of the enhancements we made this summer to our behavioral health offerings.

It is our hope that by identifying and sharing prescribing concerns, we can collaborate to increase patient safety and improve clinical care and outcomes.

"The number of opioid overdoses still occurring in this country requires a coordinated effort across the entire delivery system," said Ben Kurian, MD, Executive Medical Director of Risk Identification & Outreach Program, Health Care Service Corporation. "We hope to use our data to partner with providers for the benefit of patients and their families."

At Blue Cross and Blue Shield of Montana, we are always working to improve health outcomes for all our members. Thank you for helping ensure the safety and wellbeing of your patients/our members.

1 Source: Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49. DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1

2 The Behavioral Health program is available only to those members whose health plans include behavioral health benefits through Blue Cross and Blue Shield of Montana(BCBSMT). Some members may not have outpatient behavioral health care management.
Members can check their benefit booklet, ask their group administrator or call Customer Service to verify that they have these services.

This is only a brief description of some member plan benefits. Not all benefits are offered by all plans. For more complete details, including benefits, limitations and exclusions, please refer patients to their certificate of coverage.