This report focuses on clinics and health plans serving low-income populations, which face a tremendous challenge -- how to provide compassionate care for patients dependent on high-dose opioids, in the face of a growing epidemic of narcotic addiction and overdose deaths. The California HealthCare Foundation's California Improvement Network, a community of organizations engaged in improving health care delivery, convened leaders from health plans, community clinics, and government agencies on November 5, 2014. The goal of this convening was to devise a menu of approaches appropriate for California clinics and Medi-Cal health plans. The group talked about the current challenges facing providers caring for patients on high-dose opioids and about promising models for treatment, and converged on a set of approaches for organizations focused on low-income patients:
- Create broad community coalitions.
- Build a culture of safe prescribing by establishing consistent clinical and operational practices.
- Offer provider training programs and resources.
- Create multidisciplinary teams to work with patients on high-dose opioids or with complex conditions.
- Spread medication-assisted addiction treatment options.
- Deploy utilization and reporting tools to support safer prescribing.
- Explore payment reform to support integrated care.
- Develop and report outcome measures.
- Convening participants agreed that because the epidemic of opioid overuse has many causes, its eradication will take the coordinated efforts of players from across the health care sector and from the community.