CareFirst BlueCross BlueShield Announces New Efforts to Combat Opioid and Substance Use in Communities and Among its Members

$1.5 Million in Community Funding; New Treatment and Prescribing Initiatives

Baltimore, MD (December 13, 2017) - CareFirst BlueCross BlueShield (CareFirst), today announced new efforts to combat the region’s opioid crisis in the communities it serves, as well as programs to address substance use disorders and provide addiction and behavioral health services to CareFirst members. The efforts include $1.5 million in funding for non-profit community organizations for programs aimed at addressing substance use disorders, as well as new prescribing limits and treatment programs to limit opioid abuse and improve care for members battling addiction.

“The impact of opioids in the region we serve has been well documented,” said CareFirst President and Chief Executive Officer Chet Burrell. “As the region’s largest health insurer and one with a unique community mission, we want to take a comprehensive approach to address the opioid crisis for the greater community, as well as to create and promote policies and programs for our members that address addiction and its disastrous health impacts on the individuals and families we cover.”

“Far too many individuals are familiar with the toll on our community caused by the use and abuse of opioids. It takes a toll on individuals, families, and the entire community. The Baltimore City Health Department (BCHD) has developed a comprehensive, three-pillar strategy to combat opioid addiction: prevent deaths from overdose and save lives, increase access to on-demand treatment and long-term recovery support, and provide education to reduce stigma and prevent addiction,” said Baltimore Mayor Catherine E. Pugh. “But, this is one of those situations which you can never do enough to address, and where you always welcome additional partners and resources. I’m glad to be here today with representatives of CareFirst BlueCross BlueShield. We know CareFirst as the area’s largest health insurer, but the company is also one of the biggest corporate philanthropists in the region, and this effort is a great example of their commitment to greater Baltimore.”

CareFirst is taking a number of steps to address opioid and substance use disorders:

  • Funding for Community-Based Initiatives: CareFirst will issue a request for proposals (RFP) to community non-profit organizations serving the company’s Maryland, Washington, D.C. and Northern Virginia Service area. Through the RFP to be issued in the 1st Quarter of 2018, a total of $1.5 million will be awarded for programs and initiatives designed to directly address opioid use, addiction, and related issues.
  • Expanded Network of Specialized Addiction Recovery Centers: CareFirst has in place and continues to develop a network of high-performing addiction recovery centers. These partners are leaders in intensive outpatient programs, providing highly individualized treatment, including relapse prevention, coping strategies and medication assisted treatment.
  • New Behavioral Health and Substance Abuse Program: Because many individuals with addiction have co-occurring medical and behavioral health disorders, CareFirst has developed a Behavioral Health and Substance Use Disorder program through which primary care providers, nurses, and behavioral health providers can refer CareFirst members. In the program, members are assessed and connected to specially trained clinicians who work one-on-one with patients to identify mental health providers, assist with access, and coordinate their overall care.
  • New Quantity and Duration Limits: Based on Centers for Disease Control Guidelines for the Management of Chronic Pain, CareFirst implemented in October of this year new requirements related to opioid prescription quantity and duration limits.
  • Enhanced Prescription Drug Monitoring: CareFirst monitors controlled substance pharmacy data to identify members with multiple prescribers/pharmacies, excessive use and high claims costs which indicate behavior patterns that signal possible misuse. Pharmacists notify providers of the member’s utilization history and work with them to outline and address concerns.

“All of these efforts are intended to work together, both to address what has become a public health crisis, and beyond that to treat addiction for what it is – a chronic disease,” said Dr. Daniel Winn, CareFirst Senior Medical Officer and Vice President. “Unfortunately, only one in ten people in the United States with addiction to alcohol and drugs are diagnosed and receive treatment – compared to 70 percent with hypertension or diabetes. Community-based efforts, new guidelines and programs to staunch the dangerous flow of opioids, and programs that comprehensively treat addiction and its attendant medical issues, are all necessary to address this pressing problem.”

The community funding RFP is expected to be released in the first quarter of 2018. Details on how to apply and specifics on the types of programs eligible for funding will be available at that time at CareFirst Community.

About CareFirst BlueCross BlueShield

In its 79th year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.2 million individuals and groups in Maryland, the District of Columbia and Northern Virginia. In 2016, CareFirst invested nearly $44 million to improve overall health, and increase the accessibility, affordability, safety and quality of health care throughout its market areas. To learn more about CareFirst BlueCross BlueShield, visit our website at or follow us on Facebook, Twitter, YouTube, LinkedIn, Instagram or Google+.