INDIANAPOLIS, March 17 /PRNewswire/ -- Anthem Blue Cross and Blue Shield announced today that it has received a national award from researchers at Harvard Medical School and the Blue Cross and Blue Shield Association (BCBSA) for its innovative program designed to help physicians and other health care professionals identify patients’ questionable narcotic drug use patterns.
The recognition is part of the BlueWorks program, a unique collaboration between BCBSA and Harvard Medical School’s Department of Healthcare Policy. The initiative showcases programs from Blue Cross and Blue Shield health plans throughout the country that effectively keep quality health care affordable.
According to a government report, prescription drugs account for between 25 and 30 percent of all drug abuse in the United States and an estimated 31 million Americans have used painkillers without a medical need.
To help address this growing public health concern, Anthem Blue Cross and Blue Shield, in partnership with Anthem Prescription Management, introduced an innovative program designed to identify questionable narcotic drug patterns among members. Anthem’s clinical pharmacy staff identified a specific pattern of pharmacy claims among members, potentially indicating abuse or overmedication with narcotic prescriptions. Specifically, the team identified a “Rule of Three” pattern: three or more narcotic prescriptions written by three or more physicians and filled at three or more pharmacies within a three-month period.
When members with pharmacy claims that meet these criteria are identified, an educational mailing is sent to prescribing physicians. Included in this mailing are pain management guidelines and a member-specific profile that gives each prescriber a view of the member’s use of narcotic medication. With this information, physicians and their patients can discuss the level of narcotic use.
The program, which was piloted in Indiana, Kentucky and Ohio, has expanded to include eight Anthem Blue Cross and Blue Shield plans.
“Through this innovative program, we have provided an important tool to help improve the management of pain treatment. Our members benefit from enhanced communication with their physicians, and health care professionals benefit from having additional treatment information about pain management,” said Samuel Cramer, M.D., medical director for Anthem in Indiana, Kentucky and Ohio. “We are honored to be recognized by Harvard Medical School and the Blue Cross and Blue Shield Association for our efforts to improve the quality and affordability of health care.”
Through the BlueWorks program, BCBSA and Harvard Medical School work together to evaluate Blue Cross and Blue Shield company initiatives that address health care affordability and quality. Each quarter, a panel of experts from Harvard Medical School’s Department of Healthcare Policy selects a number of Blue Plan initiatives that have proven effective in improving the affordability and quality of care. Winning programs are published in BlueWorks Quarterly and promoted throughout the Blue system and the health care industry as examples of programs that can be replicated to help keep quality health care affordable in the United States. For more information about the BlueWorks program, visit http://www.bcbs.com/blueworks . The Blue Cross and Blue Shield Association is an association of independent Blue Cross and Blue Shield Plans.
Anthem Blue Cross and Blue Shield is a subsidiary of WellPoint, Inc. . WellPoint, Inc. is an independent licensee of the Blue Cross and Blue Shield Association and serves its members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), Wisconsin; and through HealthLink and UniCare. Additional information about WellPoint is available at http://www.wellpoint.com/ .
Anthem Blue Cross and Blue Shield
CONTACT: Debbie Davis, Anthem Blue Cross and Blue Shield,+1-317-488-6207; Chip Palazzo, Anthem -- Northern Ohio, +1-216-643-0101, KimReam, Anthem -- Central/Southern Ohio, +1-513-682-8863, Jim Gavin, Anthem --Kentucky, +1-317-287-6051, or Kelly Merryman, Anthem -- Indiana,+1-317-287-6322