During the first nine months of 2018, there were over 1,500 deaths in Massachusetts due to the opioid crisis. In response, Tufts Health Plan has joined a growing list of health plans across the country adopting eight “National Principles of Care” for treatment of addiction.
In November 2017, 16 healthcare payers, who collectively serve over 248 million people, announced a commitment to adopt the eight principles. The organizations were Aetna, AmeriHealth Caritas Family of Companies, Anthem, Inc., Beacon Health Options, Blue Cross Blue Shield of Massachusetts, CareOregon, CareSource, Centene Corp., Cigna, Commonwealth Care Alliance, Envolve Health, Horizon Blue Cross Blue Shield of New Jersey, Magellan Health, UnitedHealth Group, UPMC Insurance Division, and WellCare. They agreed to identify, promote and reward substance use disorder (SUD) treatment that aligns with the National Principles of Care.
Shatterproof, a national nonprofit organization dedicated to ending the devastation addiction causes families, is spearheading the initiative.
"We are proud to join this national effort and collaborate with Shatterproof to improve access and care in substance use disorder treatment,” said Paul Kasuba, M.D., chief medical officer at Tufts Health Plan, in a prepared statement. "These principles are another important step that Tufts Health Plan is taking to ensure our members are receiving the best care possible, at the highest quality."
The principles include:
- Universal screening for substance use disorders across medical care settings
- Personalized diagnosis, assessment and treatment planning
- Rapid access to appropriate substance use disorder care
- Engagement in continuing long-term outpatient care with monitoring and adjustments to treatment
- Concurrent, coordinated care for physical and mental illness
- Access to fully trained and accredited behavioral professionals
- Access to FDA-approved medications
- Access to non-medical recovery support services.
As part of its commitment, Tufts Health Plan will also serve on the Substance Use Disorder Treatment Task Force, launched in April 2017 by Gary Mendell, founder and CEO of Shatterproof, and Thomas McLellan, M.D., founder and chairman of the Treatment Research Institute and former Deputy Director of the Office of National Drug Control Policy under President Obama. The Task Force will develop metrics to measure progress on this initiative and will publish regularly. (Mendell founded Shatterproof to spare others the tragedy his family suffered with the loss of his son Brian to addiction in 2011. He founded HEI Hotels & Resorts and is the former president of Starwood Lodging Trust.)
Tufts Health Plan, which has more than 1.16 million members in Massachusetts, Rhode Island, Connecticut and New Hampshire, has several initiatives to address the opioid epidemic, including a substance use disorder navigator program. The navigators help members and their families understand treatment options, benefits and coverage; make decisions about next steps; find resources available to them and find solutions that fit their situation on a case-by-case basis. This personalized attention allows members to capitalize on the spectrum of treatment options.
