Study: Health Spending Related To Opioid Treatment Rose More Than 1,300 Percent
Study: Health Spending Related To Opioid Treatment Rose More Than 1,300 Percent

Study: Health Spending Related To Opioid Treatment Rose More Than 1,300 Percent

The nation’s ongoing opioid problem comes with staggering physical and emotional costs to patients and families. But the dollar cost to the health system has been harder to peg. Now a new report shows a more than 1,300 percent rise in spending by health insurers in a four-year period on patients with a diagnosis of opioid dependence or abuse.

September 29, 2016

 

From 2011 to 2015, insurers’ payments to hospitals, laboratories, treatment centers and other medical providers for these patients grew from $32 million to $446 million — a 1,375 percent increase.

While that’s a small portion of the overall spending on medical care in the United States, the rapid rise is cause for concern, says Robin Gelburd, president of Fair Health, a nonprofit databank that provides cost information to the health industry and consumers.

“That really shows the stress on the health system and the impact on the individuals,” said Gelburd.

The Fair Health study found a sharp difference in how much insurers spend on individual patients with such a diagnosis.

On average, insurers spend $3,435 a year on an individual patient, but for those with an opioid dependence or abuse diagnosis, that amount jumps to $19,333. Those numbers reflect what insurers actually paid. The report also includes data on what providers charged, amounts that are lowered by their contracts with insurers.

The study, set to be released Tuesday, builds on one Fair Health released in early August that found a 3,000 percent increase in the volume of insurance claims related to opioid dependence diagnoses between 2007 and 2014.

The latest study — part of a series — offers amounts associated with claims billed by providers and paid by insurers for the types of medical services used.

Both studies use de-identified claims data from insurers representing more than 150 million insured Americans who either have insurance through work or buy coverage on their own.

There have been other efforts by several researchers to quantify the cost of the opioid problem on the overall economy, estimated in the tens of billions of dollars.

The new report adds to the available data “that it’s not just the human cost associated with the opioid crisis that is enormous, but also that the economic costs are staggering,” said Dr. Andrew Kolodny, senior scientist at Brandeis University. He did not work on the study.

The surge in spending on patients with opioid diagnoses is likely a combination of factors, the report notes. As media attention focuses on drug dependency, more people may be seeking treatment. At the same time, prescription and illegal use of narcotics may also be increasing.

The study found that emergency room visits and laboratory tests accounted for much of the spending. Based on claims volume, the fastest-growing set of services in terms of utilization were for alcohol or drug therapy. Lab tests, including checks for barbiturate or opioid use, were not far behind.

Researchers did not use 2015 data for lab test costs, noting that a change in billing codes was made that increased the number of categories — and, in some cases, appear to generate higher payments by insurers. It is too early to estimate the long-term effects of the change, Gelburd said.

The report gives some examples of the changes, however. For example, one billing code for a test on opiate use commonly brought in a $31 payment from insurers prior to the change. The two billing codes that replaced it now are commonly paid at $78 and $156.

The new billing codes may reflect new technology in testing, said Gelburd. She said some observers speculate that the rapid increase in lab spending might reflect that, with more patients in therapy, the tests are being used to ensure they are taking their proper medications and not abusing narcotics.

But the spending might also reflect a growing use of very expensive urine and blood tests when less expensive ones would be sufficient, said Kolodny.

“I worry about profiteering,” said Kolodny. “We do need tests, but not the expensive ones. A lot of clinics are making extra money off these lab tests.”

The overall increase in spending across all types of medical services “is a societal issue,” said Gelburd, who says policymakers need to ensure that changes are made to address the problem.

“Are medical school curricula adjusting to recognize the growing need for these services? Are insurers increasing the number of providers in their networks to ensure sufficient access? Are consumers being educated? It’s an issue that has to be dealt with in all quadrants.”

About Author

50722 Responses Found

  • Comment Link
    Arlen Sunday, 23 April 2017 22:16

    I'm new to your blog. Stumbled upon it while surfing around the internet.
    Continue the fantastic work. I'm hoping you update
    it on a regular basis since I'll be staying tuned for more.

  • Comment Link
    Evelyn Sunday, 23 April 2017 22:14

    Outstanding post from specialist. Thank you very much for writing this helpful info for
    all of us.

  • Comment Link
    Alejandrina Sunday, 23 April 2017 22:13

    Thanks so much for sharing all of the awesome information!
    I am looking forward to checking out more posts!

  • Comment Link
    Gabriel Sunday, 23 April 2017 22:09

    Have you ever considered regarding adding a
    little bit more than just your posts? I mean, what you say is fundamental and everything.
    Nevertheless think about if you included some good pictures or video clips to give your posts more, “pop”!
    Your content is outstanding however with images and clips, this
    website could certainly be one of the most beneficial in its field.
    Great blog!

  • Comment Link
    Isabelle Sunday, 23 April 2017 22:07

    Pretty section of content. I just stumbled upon your
    website and in accession capital to assert that I acquire actually enjoyed account your blog posts.
    Anyway I'll be subscribing to your augment and
    even I achievement you access consistently fast.

  • Comment Link

    That item ended up being with that ideal rate I not thought the quality is so that exceptional. Its striking. The mom is going to appreciate information technology concerning Christmas day whenever she starts present and it styles like I devoted much more, then again prices was exclusively very good!!

  • Comment Link
    Elton Sunday, 23 April 2017 22:06

    I don't think I've read anything such as this before. So good
    to find somebody with some unique thoughts on this subject.
    great one for starting this up. This site is something that is needed on the web, somebody witha bit of creativity.
    Very good job for bringing something new to the
    net!

  • Comment Link
    Micheline Sunday, 23 April 2017 22:00

    Good post. I learn something totally new and challenging on sites I
    stumbleupon everyday. It's always useful to read through articles from other writers and use a little something from their websites.

  • Comment Link
    Margart Sunday, 23 April 2017 21:59

    Outstanding post, you have pointed out some excellent details,
    I believe this is an excellent site.

  • Comment Link
    Kimber Sunday, 23 April 2017 21:57

    After study several of the blogs on your website now, and I really
    like your way of writing a blog. I bookmarked it to my bookmark website list and will be
    checking back soon. Pls take a look at my web site too
    and let me know your opinion.

Leave a comment

Make sure you enter the (*) required information where indicated. HTML code is not allowed.