May 21, 2020

HOW HEALTH INSURERS CAN REDUCE THE ECONOMIC IMPACT OF OPIOID ABUSE

The epidemic of opioid misuse and abuse is having a profound economic impact on the healthcare system. In just five years, the claims charged to insurance companies to treat opioid dependence or abuse grew from $72 million to $722 million — an increase of almost 1,000%, according to Optum. The Rising Costs of Opioid Abuse to Health Payers A 2015 study of privately billed services found private payers’ average costs for a patient diagnosed with opioid abuse or dependence were more than 550% higher—almost $16,000 more per patient—than the per-patient average cost based on all patients’ claims. Opioid Abuse Costs Payers Up to $16,000 Per Patient Per Year In 2015, the per-patient charge average (across all diagnoses and all claim types for all patients in the dataset) was $11,404. The per-patient average total charge for a patient identified with an opioid abuse or dependence diagnosis for the same year was $63,356.  With respect to the amounts that are allowed by the insurance companies on a per-patient basis, the difference was 563%: the per-patient average allowed amount for all patients was $3,435 compared to the ...