Payer Empowers Grassroots Movement to Tackle Opioids Epidemic

While payers are pursuing high quality substance abuse care for their members, supporting employees through substance abuse and reducing stigmas around the opioids epidemic is equally critical, Highmark Health (Highmark) found.

Highmark has developed a robust substance abuse care agenda which has produced 70 percent fewer opioid overdoses among its commercial members in the last three years. This is especially significant since Highmark serves West Virginia and Pennsylvania, two states that were in the top ten for opioid overdoses per 100,000 individuals in 2018.

The payer also worked to diminish opioid prescriptions, successfully lowering them by 25 percent in the past three years. In addition, Highmark has introduced the Opioid Epidemic Education Program to local school systems, educating over 10,000 students and adults about the opioid epidemic.

But underneath the surface, employees were restless to do more.

Back in May 2019, Ashley Potts, senior project manager at Highmark, watched an all-employee meeting on opioids blossom into an employee-driven movement toward reducing stigma and empowering substance abuse care advocacy within the payer organization itself.

Potts was presenting on opioids at the meeting along with Caesar DeLeo, vice president and executive medical director of strategic initiatives at Highmark, and other presenters.

“There was a large response and individuals wanted to share how substance use disorders have personally affected them, their family, their communities, and people really wanted to be able to help,” she described to HealthPayerIntelligence.

DeLeo could sense employee energy around this topic as well.

“The emotion was palpable,” DeLeo agreed. “We knew that people just needed an outlet. Through a group, like LEARN, it's very grassroots. To whatever degree they wanted to advocate and promote recovery and network, they could do that.”

While DeLeo and Potts underscored that this was a very grassroots movement, the two did meet after the presentation to brainstorm ways that Highmark could provide the outlet that employees clearly desired. The LEARN group emerged in part from that brainstorming session.

LEARN is an acronym for Learn, Educate, Advocate, Support, and Network. These words encapsulate the group’s primary goals, in which employees:

• Learn more about substance use disorders
• Educate others
• Advocate for reforms and effective substance abuse care
• Support recovery
• Network amongst themselves and with their communities to challenge stigmas and reduce substance abuse harm

On Valentine’s Day in 2020, the LEARN group had its first meeting. Over 300 employees participated on a Friday afternoon to hear from Potts and DeLeoa and give input.

Potts and DeLeo invited employees to join a three-part advisory group — learning and education, advocacy and support, and networking — to guide the grassroots movement. Thirty-six employees volunteered to be on the advisory group and they arrange for speakers each month to address relevant topics.

“So we have people looking at how do we become a recovery friendly work environment? How can we develop more learning curriculum? How can we network in the community and within the enterprise?” Potts shared. “We have experts at all of those levels, all different positions, bringing different expertise.”

One of the key strengths of this grassroots program has been Highmark’s integrated health system. It lends the group a diverse range of healthcare system perspectives, DeLeo pointed out.

"Participants in the LEARN group not only come from Highmark, the insurer, but they come from our Medicaid plan, they come from our dental plan, they come from our hospital setting and our practices. So we bring a broad and diverse perspective to the membership of the group,” DeLeo said.

Potts indicated that from the beginning of this movement Highmark kept an open line with employees, setting up a separate email address so that employees could reach out with ideas for the LEARN group.

The group has a very low impact on resources, requiring only a Zoom line and assistance arranging for speakers.

Thus, the key lies not in the resource outlays, but rather in the employees themselves, both Potts and DeLeo agreed.

“It was very ground-up, it wasn't a top-down program,” DeLeo emphasized. “It was really tapping into the energy of the folks who are in your own organization, who want to do something. And I think that was the secret sauce.”

Since the kickoff in February 2020 which drew 300, the group has more than doubled, including over 700 Highmark and Allegheny Health Network employees.

As a result of this grassroots approach, the future for this program and its potential impact on Highmark’s other substance abuse care programs is very open-ended. DeLeo and Potts had several ideas about the direction that it could take, such as creating a speakers bureau or working within Highmark to challenge stigmas.

Already the organization has thrown together an event for International Overdose Awareness Day, a simple ceremony in which employees could speak the name of their loved one who passed away due to overdose in order to remember them.

“There's always been a lot of emotional drive for this kind of topic, especially with the overdoses continually increasing across the nation,” Potts said. “So the momentum has always been there, but this is just giving us the opportunity to tap into that momentum to really try to create change.”

Payers have found a variety of ways to address the opioid epidemic, including substance abuse care programs, supporting overdose survivors, and helping NICUs care for infants experiencing opioid withdrawal.

Especially with the onset of the coronavirus pandemic, payers have emphasized the role of employers in improving workplace wellness and identifying potential substance abuse.

While some progress has been made, such as the drop in opioid overdoses by two percent between 2017 and 2018, it will take cultural reform at all levels—both outside of payers and internally—to put an end to the opioids epidemic.