Louisville residents who have employer-based insurance through Anthem will soon have access to a new addiction treatment program run through a local recovery center.
Amanda Newton, the CEO of Louisville-based Renew Recovery, said the program is a little different from what the center currently offers. Instead of having to go to a brick-and-mortar location, Anthem enrollees will stay at home to receive treatment. Newton said this will remove a barrier to treatment that exists for a lot of people.
“Treatment historically is set up for folks that have lost everything,” Newton said. “So what do we do about the people that still have jobs and families that are struggling? I thought we should meet them where they are instead of meeting us where we are.”
At-home treatment is common in behavioral health, but pretty new to substance abuse treatment. That’s why Anthem is calling the benefit a pilot.
Mike Lorch, Anthem regional vice president for provider contracting, said there are more options for addiction treatment for people who might not have a job and have hit rock-bottom, and are able to spend time during the day at a treatment program.
“There’s more treatment for that Medicaid population, more options,” Lorch said. “This employed group is the untreated population right now that haven’t had a lot of options. You either go off to Florida or California for a 30- or 60-day treatment plan, or you just continue to spiral.”
How It Works
Enrollees can call Anthem or Renew Recovery to get an initial assessment. Qualifications include factors like having a safe home and family support.
The program will send a therapist and psychiatrist to an enrollees’ home for an initial visit to set up a treatment plan. That would likely include daily telehealth visits with a therapist, virtual group therapy and visits from a peer support specialist to check in on an enrollee’s progress. After two months of the intensive program, the enrollee can either continue with outpatient behavioral therapy for up to two years at Renew or with another therapist. The treatment plan might also include medication assisted treatment, like the drug naltrexone, administered by a pharmacist.
Jeff Reynolds, medical director of Anthem Blue Cross and Blue Shield in Kentucky, said the insurance company is hoping there will be a benefit to enrollees getting treatment at home. He said inpatient treatment that lasts for a finite amount of time doesn’t always equip people with the skills needed to handle their addictions back home.
“And then you walk back into reality, you have to deal with the real: and the real is that those triggers are there,” Reynolds said. “This way, we’re addressing the triggers where they happen.”
Reynolds said Anthem’s pilot project doesn’t have a ceiling on how many people can get treatment, or a deadline for when they’ll no longer offer the benefit. The goal is to track outcomes and potentially expand it nationally.
Lorch said Anthem also doesn’t have an estimate on how many enrollees might use the benefit, but that it will be open to almost one million current customers with Anthem’s employer-based insurance.
“It’s hard to estimate because this is an audience that hasn’t been served before,” Lorch said. “We don’t know how many people are out there that have an addiction that are still functioning, and if this treatment were available, would seek it out.”
And Lorch says there’s another potential benefit: the program may save both enrollees and the insurance company money. Research shows that when a person has a chronic disease in addition to a substance abuse disorder, their overall medical costs are higher. That’s because of factors like forgetting to take medicine or spending money on illegal drugs rather than treatment for chronic conditions.
“”We’ve seen that time and time again – they probably have close to twice the medical spend as somebody in their same demographic that doesn’t have that [substance abuse disorder] diagnosis,” Lorch said.
Newton with Renew Recovery said about 60 percent of the treatment center’s clients have Anthem insurance, so the partnership was a natural fit. The addiction recovery center is also in talks with other insurers.