Author: Justin Mckibben
When we talk about national addiction recovery, what we mean is acknowledging how we as a country and a culture are recovering in our communities. How are we supporting those in addiction treatment? What services are we making available? How is our economy recovering? What are we doing to prevent the spread of addiction?
So if we are taking away resources that not only treat those already struggling, but also prevent more people from suffering, how do we expect to ever escape the devastation caused by the opioid epidemic and rise of overdose deaths?
One of the most divisive issues facing America today is access to healthcare and the extent to which health coverage should or should not be provided. The debate has gone on for a long time, and in the shuffle of each proposal, it seems mental health and addiction services are constantly threatened. Recently there have been more attacks on addiction treatment access. So how is the possibility of more decreases in health coverage going to hurt national addiction recovery?
The Parity Protections
Once upon a time in 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) created guidelines that required health insurers to treat mental health and addiction coverage exactly the same as they would with medical and surgical care options. So this means that prior to the MHPAEA those who were lucky enough to have health insurance still could not be guaranteed to receive equitable benefits for mental health or substance abuse care.
These protections were even further expanded by the Affordable Care Act (ACA) and legislation put forth by Congress in 2016 with the 21st Century Cures Act, which includes tougher enforcement of parity requirements.
Since the Trump administration stepped in adamantly proclaiming the goal or repealing and replacing the ACA there has been a lot of concern about whether or not any new proposals will decrease health coverage for mental health and addiction services. Many addiction and mental health advocates worry that parity protections and enforcement will also lose their power.
As of yet, politicians are still hoping for a compromise that will keep the protections and resources for treating addiction and mental health intact.
BCBS Cuts Mental Health Coverage
One instance of concerning changes in policy has come out of Minnesota. Just this September the largest insurance carrier in the area, Blue Cross Blue Shield, is making drastic decreases to payments to mental health providers.
We are talking about cuts in addiction and mental health coverage to the tune of that’s 33%!
This decision came after a recent survey showed that the individual therapy costs of Minnesota had exceeded the national average for the last two years. But mental health professionals immediately spoke out against this move. Protests actually took place on Thursday the 14th outside the headquarters of Blue Cross Blue Shield in Eagan, MN. Many advocates and protesters are saying these kinds of cuts will put mental health clinics out of business.
The insurance provider is now under fire as caregivers insist this change will discourage necessary, extended psychotherapy services. People in Minnesota see decisions like that of BCBS as being a violation of the protections offered by parity.
If this kind of policy shift within insurance providers becomes a trend, we could see a dramatic decrease in the people getting substance abuse and mental health treatment. These changes can hurt our national addiction recovery by slowly cutting off the people who need every chance they can get, especially during a devastating opioid epidemic.
Threats within Medicaid
Believe it or not, Medicaid is currently the single largest payer for behavioral health services in America. Threats to the Medicaid health coverage of services like this could do critical damage.
At one point the Trump administration and congressional leaders seemed partial to the idea of turning Medicaid into a block grant program. This strategy would give states a fixed amount of money to provide healthcare for low-income residents. However, policy experts say that means states would have to:
- Reduce eligibility
- Narrow the scope of benefits
- Impose cost-sharing requirements
All of which would also impact the number of people seeking substance abuse and mental health treatment.
Recently GOP representatives and the Trump administration began the work of fundamentally altering state Medicaid programs. Some of these new requirements include governors pushing for:
So again, there is the very real possibility of more hurdles being put in-between those who need help and the already limited resources available to them.
Stigma Influencing Policy
The bigger part of this issue is that these shifts are happening in a way that shows how stigma is influencing policy. We are only further hurting our national addiction recovery by letting this idea that addiction is a moral failing or class issue limit what we are willing to provide to those who need help.
The reason behavioral and mental health services are so crucial is because the cause of addiction is not just the drugs themselves. The vast majority of recovery advocates endorse the concept that addiction develops from multiple factors, such as:
- Lack of access to resources
- Poor social networks
So in fact, by limiting coverage to mental health services, the problem could be magnified.
Mental health services like behavioral therapy being lost with a decrease in coverage means that more children and young adults could go without the support systems. What this does is puts more people in the exact circumstances where we see substance abuse and addiction grow.
So in essence, not only could these constant threats to addiction and mental health coverage be taking away treatment for those already addicted, but it also takes away from prevention programs in communities that fight to keep addiction rates down.
National Addiction Recovery Effects Everyone
If we have any hope of having sustainable national addiction recovery then it is vital that our country continues to push for mental health parity in every discussion about healthcare. If we ever hope to overcome the demoralization of communities we have to fight for mental health and addiction services.
This isn’t about treating the individual’s symptoms with just medications either. Access to other crucial elements like housing, medical care, and basic preventative measures all contribute to the overall mental health of any individual.
When people have better access to the specific levels of care they need, we empower them to contribute to the better communities we need for healthy nation-wide recovery.
People struggling with substance abuse and mental health disorders deserve comprehensive and compassionate treatment, and we should all fight to protect coverage that makes treatment more available. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Shernide Delva
These are just a few of the incentives doctors have received from prescription opioid companies. Did these goodies get you your last opioid prescription?
Could incentives be responsible for our current opioid epidemic?
That’s exactly what researchers set out to understand.
A recent report confirmed what many have suspected: doctors are receiving incentives from major opioid makers. In fact, one out of every 12 U.S doctors gets money, lunch or something else of value from companies that make opioid drugs, the study concluded.
Furthermore, companies are spending more time and effort marketing opioids to doctors than they are other less addictive painkillers. These finding will help understand why doctors have played such a major role in the opioid addiction crisis.
“A large proportion of physicians received payments — one in 12 physicians overall,” said Dr. Scott Hadland of the Boston Medical Center. “Tens of millions of dollars were transferred for marketing purposes for opioids.”
Dr. Hadland and colleagues went through databases from the Centers for Medicare and Medicaid Services, the federal government office that oversees public health insurance.
The 2010 Affordable Care Act includes the Physicians Payments Sunshine Act. This act required medical product makers to report any offerings or goodies made to doctors or to teaching hospitals. However, incentives are often disguised as something else.
“In some cases, they are money provided directly to physicians — for example, the speaking fees, the consultant fees and the honoraria. In other cases it is reimbursement for things like travel,” Hadland said.
On average, doctors get a single “payment,” usually a mean worth of $15 about once a year. Still, there are a select few doctors that are reaping the most benefits.
“The top 1 percent of physicians (681 of them) received 82.5 percent of total payments in dollars,” the team wrote in their report, published in the American Journal of Public Health.
These incentives could influence doctors to prescribe opioids to their patients:
“One of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” the study notes.
Between 2013 and 2015, the team found 375,266 payments totaling 26 million distributed to more than 68,000 doctors.
While larger fees mostly accounted for speaker fees, more leisurely incentives like food and drink accounted for 94 percent of the payments.
“I do think the practice is exceedingly common. Increasingly, medical schools are restricting the ability of pharma companies to come to speak to medical students and even faculty,” Hadland said.
With all this said, do small incentives really make a difference? After all, can a doctor really be bought for the price of a boxed lunch?
The research indicates that, yes, these little goodies do influence prescribing. Last year, a study revealed that physicians who accepted even one meal by a drug company were more likely to prescribe a name-brand drug to patients later.
This is not the first time investigations were conducted on possible incentives. After earlier controversies and studies, the Pharmaceutical Research and Manufacturers of America issued a voluntary code of conduct to curb the once widespread practice of handing out free mugs, prescription pads, and other swag covered in drug brand names.
Some cities and states especially hit by the opioid abuse epidemic have even sued drug makers saying their practices have helped fuel the problem. The CDC states doctors have contributed to the addiction crisis by prescribing opioids to too many patients. These prescriptions are often prescribed at high doses for too long which only increases the vulnerability to addiction.
The result is deadly.
There were more than 30,000 fatalities in the United States in 2015, the federal government said.
“I think that first and foremost we have known that one of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” said Michael Botticelli, former director of the White House Office of National Drug Control Policy, and now executive director of the Grayken Center for Addiction Medicine at the Boston Medical Center.
According to Botticelli, the answer is independent education, free of the need to promote a specific product.
“At the federal and state level (we may need to) move toward mandatory prescriber education to counteract industry’s influence over prescribing behavior,” he said. “Clearly, guidelines are not enough.”
For a long time, prescribing opioids was one of the first responses to pain management. Now other alternatives are being promoted such as pain management devices and holistic alternatives.
Botticelli agrees that while pain is a major problem, the answer is not more opioids.
“Yes, we want to make sure people’s pain is appropriately treated, but we know that longer and higher doses have significantly added to the addiction problem that we have in the United States,” he continued.
What are your thoughts? Did you know about these incentives? More studies are coming out revealing the back story to what led to the prescription opioid epidemic.
Opioid addiction has become a public health crisis. Now, more than ever is the time to seek treatment. Recovery is possible. You do not have to feel out of control. There is a solution. If you are struggling with substance abuse, call now. Do not wait.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
The new Trumpcare plan, formally known as the American Health Care Act or AHCA was announced this Monday March 6th. This Trumpcare bill is the Republican Party’s long awaited plan to repeal and replace the Affordable Care Act, also known as Obamacare.
Since day one of the announcement we have seen quite a few varying opinions as to what this means for the people who were previously covered, and what it means for how healthcare altogether might change. Needless to say, not that much of the talk has been optimistic. As details emerge about Trumpcare some have become increasingly worried about the impact it will have on access to treatment for substance use disorder, especially for low-income Americans.
So what some are officials and experts saying about Trumpcare, and what it might mean for Americans struggling with addiction?
Early Predictions on Trumpcare
According to some early reports, 6-10 million Americans will lose health insurance. Not only that, millions of people in desperate need of help could be cut off from access to addiction treatment as a result of the bill.
In fact, according to one analysis, approximately 2.8 million people living with substance use disorder will lose some or all of their health insurance coverage if Obamacare is repealed. This conclusion comes from:
- Harvard health economist Richard Frank
- Sherry Glied, Dean of the Wagner School of Public Service at NYU
The publication The Hill reported in January that Frank and Glied predict that the federal government’s 21st Century Cures Act creates a recent investment of $1 billion to tackle opioid abuse. However, they state this provision would be- “squandered if the new Congress rolls back recent gains in the quality and level of substance use and mental health insurance coverage generated by the Affordable Care Act (ACA) of 2010.”
Surely this is all “fake news” and “alternative facts” right?
Not so much. According to reports from the Washington Post Thursday, House Republicans admitted, after questioning by Massachusetts Democratic Representative Joe Kennedy III, that their the Trumpcare plan to repeal-and-replace would- “remove a requirement to offer substance abuse and mental-health coverage that’s now used by at least 1.3 million Americans.”
How does this happen? By attacking the expansion of Medicaid and the ‘essential benefits’ states are required to provide for.
Trumpcare Impact on Medicaid
Trumpcare’s plan to roll back Medicaid and health insurance tax credits are pretty distressing aspect of this reform. For all the Americans who rely on government assistance for addiction treatment this is a pretty huge deal.
Addiction treatment in the past is notably impacted by Medicaid. According to Truven Health Analytics, Medicaid was the second largest payer for addiction treatment, after state and local programs, in 2014.
Starting in 2020, Trumpcare is set to:
- Freeze Medicaid enrollment
- No longer require Medicaid to cover essential health benefits like addiction treatment
What is the point? To make it so the federal government pays less for Medicaid over time by shrinking coverage.
So if this is all the case, it is a terrifying reality. In a time when more Americans than ever desperately need addiction treatment, in the midst of an opioid epidemic that is tearing families and communities apart, the government’s Trumpcare plan stands to save money by stripping addiction resources from those relying on Medicaid?
Representative Kelly and Peter Welch, Democratic Representative from Vermont, attempted to amend the bill to restore the federal mandate for those ‘essential benefits’ but were voted down. Kenny is popularly quoted in the news recently for his statement,
“There is no mercy in a country that turns their back on those most in need of protection: the elderly, the poor, the sick, and the suffering. There is no mercy in a cold shoulder to the mentally ill… This is not an act of mercy — it is an act of malice.”
While Trump’s comments say he wants to give states “flexibility” with Medicaid to make sure no one is left out, many believe this is just adding the idea of paying more for less.
Senate Minority Leader Chuck Schumer vows to lead efforts to defeat Trumpcare, stating he believes it will “Make America Sick Again” and believes that it will create more drug addicts. In a report from The Hill Schumer attacks the bill saying,
“To make matters worse, this sham of a replacement would rip treatment away from hundreds of thousands of Americans dealing with opioid addiction, breaking the President’s word that he would expand treatment, not cut it.”
This is continuously troubling. When it comes to the fight against addiction, President Trump’s administration seems to be more focused on borders and “law and order” than providing resources. Trump did promise to work on creating more coverage options, but all the action taking place almost points the opposite direction.
Trumpcare Impact on Treatment Providers
This chain reaction wouldn’t just hurt those who need insurance by denying them coverage. Experts say Trumpcare also has the capacity to do damage to the treatment providers themselves.
Keith Humphreys, a drug policy expert at Stanford University, points out this issue directly. Humphreys notes that treatment providers, which tend to be small businesses in many parts of the country, may find it difficult to stay in business if clients lose coverage for addiction treatment. If less people are able to get coverage, less people will be able to get treatment. At the same time even bigger treatment providers could have trouble because it still has the capacity to reduce reimbursement rates for treatment services.
Thus, Trumpcare could affect both the supply and quality of treatment. In one interview Humphreys states,
“Most providers are small, mono-business entities that can’t absorb costs elsewhere in their care systems,”
“While hospitals will not go broke if poor people get less oncology care coverage, many [substance use disorder] treatment agencies will.”
But it isn’t just Democrats or University Professors or addiction experts speaking out. The AARP, the American Hospital Association, and the American Medical Association voice opinions against the overhaul of the ACA and the potential harm Trumpcare could do.
Even Republicans are speaking out against the danger that Trumpcare poses to addiction. Ohio Governor John Kasich is vocal with his own opposition to the bill saying,
“[Trumpcare] unnecessarily puts at risk our ability to treat the drug-addicted mentally ill and working poor who now have access to a stable source of care.”
Not to say that healthcare was ever perfect. It is noted by many doctors in the addiction field, as well as politicians and other experts, that there is already a treatment deficit. Approximately 10% of America’s population has what could be considered a substance use disorder, and only 13% of those people ever get treatment.
However, the miles of red tape Trumpcare might wrap around them could cut that number drastically. So even if these are unintended consequences, they are very real consequences just the same.
Obamacare was far, far from perfect. This is absolutely true. But is Trumpcare the best answer we can come up with?
As it now stands, Trumpcare may take so much away from those struggling with addiction and mental health that some experts are calling it dangerous. Having safe, effective and comprehensive treatment resources for these issues is extremely important to the preservation of life and the future of America. This is a matter of life and death. It is not the time for an ‘anything but Obamacare’ mentality… if the government expects a better plan, they need to make it happen. How about we put a hold on spending billions on border walls and expanding the nuclear program, and instead focus on healing Americans who need it most.
If you or someone you love is struggling with substance abuse or addiction, think about who you want to be working with to find a real solution. Please call toll-free now.
CALL NOW 1-800-951-6135
Author: Shernide Delva
President Barack Obama will make a budget request to Congress for $1 billion dollars to fight drug abuse and overdoses. The amount of overdoses in the United States is currently at an all-time high. More than 47,000 people died from drug overdoses last year, according to the CDC. That exceeds the amount of deaths in traffic accidents. Obama’s budget request aims to expand treatment specifically to those suffering from abusing prescription opioid painkillers as well those using cheaper drugs like heroin.
The majority of the $1 billion dollars would go to states under joint state-federal agreements increase the amount of people who have access to treatment. A smaller portion of $50 million would pay for a corps of 700 providers who know how to use drugs and therapy to treat drug addiction.
“Second, the President’s budget includes approximately $500 million — an increase of more than $90 million — to continue and build on current efforts across the Departments of Justice and Health and Human Services to expand state-level prescription drug overdose prevention strategies, increase the availability of medication-assisted treatment programs, improve access to the overdose-reversal drug naloxone, and support targeted enforcement activities,” the White House said in a statement.
The drug naloxone, more commonly known by its trade name Narcan, can quickly reverse the effects of an overdose. Many states and cities are ensuring that first responders have naloxone on hand to save the lives of those who have overdosed. Recently, a variety of efforts has been made to make Narcan more readily available. Everything from having school nurses has access to the drug to making the drug available over the counter at pharmacies. With Narcan, the quicker a patient receives the drug, the better chance they have of surviving.
In the past, Obama has made it clear in the past that the opioid overdose epidemic is a priority for his Administration. Not long ago, the president issued a memorandum that served to combat the opioid epidemic through improving education and training as well as increase access to treatment. In 2012, health care providers wrote 259 million prescriptions for opioid pain medications– enough for every American adult to have a bottle of pills.
Obama went to West Virginia in October to hear personal accounts from individuals and families affected by the epidemic. West Virginia has the highest rate of overdoses in the country. He spoke to health care professionals, law enforcement officers, and community leaders working to prevent addiction and respond to its aftermath.
The President’s FY 2017 budget takes a two-pronged approach:
First, it includes $1 billion in new mandatory funding over two years to expand access to treatment for prescription drug abuse and heroin use. The funds are allotted in the following ways:
- $920 million to support and expand access to medication-assisted treatment for opioid use disorders. States can use these funds to expand treatment capacity and make services more affordable.
- $50 million in National Health Service Corps funding to expand access to substance use treatment providers. This funding will make it possible for close to 700 providers to provide substance use disorder treatment services in areas across the country most in need of behavioral health providers.
- $30 million to identify and evaluate the effectiveness of various treatment programs. This money would be used to understand the real-world conditions of drug abuse and understand the unique needs of patients with opioid use disorders.
Second, the president will increase the budget by close to 90 million for the Department of Justice (DOJ) and Health and Human Services (HHS). The increase in funds will be used to continue to implement prevention strategies as well as increase the availability of medication-assisted treatment programs. The budget includes an HHS pilot program for nurse practitioners and physician assistants to prescribe buprenorphine for opioid use disorder treatment, where allowed by state law. Another objective is to increase access to Naloxone (Narcan) with these funds. The budget includes an HHS pilot program for nurse practitioners and physician assistants to prescribe buprenorphine for opioid use disorder treatment, where allowed by state law.
Along with President Obama’s announcement come several proposals from presidential candidates for the upcoming election. It is clear that the drug epidemic is going to be a critical topic to tackle in the next coming years. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Shernide Delva
Last month, Health and Human Services Secretary Sylvia M. Burwell announced an initiative to provide $685 million in awards to 39 national and regional healthcare networks and supporting organizations. Have you ever been in a hospital where you felt more like a number than a patient? This initiative wants to address those issues that are affecting our hospitals and health care facilities nationwide. The initiative called the Transforming Clinical Practice works as a part of the Affordable Care Act.
The goal is to equip more than 140,000 clinicians with tools and support needed to mainly:
- Improve Quality of Care
- Increase Patients’ Access to Information
- Reduce Costs
The $685 million will be one of the largest federal investments given to support clinicians and will impact all 50 states through collaborative and peer-based learning networks. Secretary Burwell, elaborated by saying:
“These awards will give patients more of the information they need to make informed decisions about their care and give clinicians access to information and support to improve care coordination and quality outcomes.”
Overall, the goal is to move toward a wellness-based approach to managing care. For example, The American Board of Family Medicine will work with more than 25,000 family physicians serving 50 million or more patients to help clinicians and patients navigate the changing healthcare system and reduce disparities in healthcare.
The efforts of the initiative will accomplish the following and more:
- Help providers give patients better tools for communication
- Provide dedicated coaches to better manage chronic disease and offer preventive care
- Offer real-time notification alerts for clinicians caring for high-risk patients
- Improve screening and treatment of mental health and substance abuse across multiple care settings
- Centralize data reporting with technical assistance
- Promote patient, provider and community engagement
In the past, patients felt like nothing more than a number. The care in hospitals was becoming less personal and more data-based. As a result, this initiative hopes to accomplish fostering new levels of coordination, continuity and integration of care. The ultimate goal is to transition from volume-driven system to value-based, patient centered healthcare services.
Secretary Burwell released the awards in conjunction with a round-table discussion with Members of Congress and health care leaders. They discussed ways to transform our nation’s health care system into a system that rewards value over volume.
During the conference, it was announced that part of the funds would support 29 medical group practices, regional health care systems, and regional extension centers in offering peer-to-peer support to primary and specialty physicians, nurse practitioners, physician assistants, clinical pharmacists, and their practices.
In addition, $27 million would be given to 10 national organizations and health care professional associations in order to:
- Align clinical practice guidelines across multiple medical specialties so there is uniformity.
- Offer Continuing Medical Education credit to clinicians to support transformation efforts
- Share best practices and provide technical assistance and coaching to their members; discuss alternative payment methods.
- Provide educational materials and access to registry data information and training on how to use the data to improve care.
These awards come as part of a comprehensive strategy advanced by the Affordable Care Act to build upon successful models and programs such as the Hospital Value-Based Purchasing Organization Program, Partnership for Patients with Hospital Engagement Networks, and Accountable Care Organizations.
Americans need a health care system that delivers the right care, at the right time, and at a cost that is reasonable and easy to understand. Now patients will be able to reply on their doctors and health care team to provide them the quality of care they need. Such a system will result in fewer unnecessary hospital admissions and readmission, fewer healthcare-associated infections, and reduced patient harm, and will show continuous improvement in quality outcomes and cost efficiency.
The more efficient our health care system the better chance more people will be taken care of properly. As more and more people suffer from addiction, improving access to medical facilities becomes a more important issue. If you or someone you love is struggling with substance abuse or addiction, please call toll free 1-561-221-1125.