Insurance Company Sets Goal for Reducing Opioid Overdoses by 25%

The progress of the 2021 goal will be tracked against claims submitted with an opioid overdose diagnosis code
The progress of the 2021 goal will be tracked against claims submitted with an opioid overdose diagnosis code

Cigna has announced plans to reduce opioid overdoses by 25% among their commercial customers by December 2021 through a collaborative approach involving employers, customers, prescribing clinicians, pharmacists, and community-based organizations.

Initially, the Company will focus its efforts in Connecticut, Maryland, New Jersey, Virginia, and the metropolitan areas of Chicago, New York, Philadelphia and Washington, DC, areas with a sizable number of Cigna customers and with higher than average overdose rates.

The plan includes 4 broad areas of action: (1) expanding the use of predictive analytics; (2) enhancing pharmacy prior-authorization and quantity limit programs and requiring informed consent for patients receiving hazardous levels of opioids, while also encouraging co-prescribing of naloxone; (3) partnering with employers to help inform health plan decisions; and (4) improving primary care treatment of chronic pain in Cigna Collaborative Care Arrangements.

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Through their predictive analytics, Cigna can identify customers most likely to suffer from an overdose and can prompt interventions. Working with employers, the Company will facilitate the integration of medical, pharmacy and behavioral benefits and offer "dedicated programs that help prevent prescription drug misuse".

The progress of the 2021 goal will be tracked against claims submitted with an opioid overdose diagnosis code. Provider groups will be asked to sign a pledge to reduce opioid prescribing and to treat opioid use disorder as a chronic condition. 

"We know we can't do it alone and are collaborating with partners on local efforts to curb this preventable disease by improving care for people with chronic pain and substance use disorders," said Doug Nemecek, MD, CMO for behavioral health at Cigna. 

For more information visit Cigna.com