HJBR Jul/Aug 2019

Healthcare Journal of Baton Rouge  I  JUL / AUG 2019 47 Stewart T. Gordon, MD, FAAP Chief Medical Officer, Medical Affairs Louisiana Healthcare Connections The department also made national news by enacting a standing order for nal- oxone, an opioid antagonist that rapidly reverses opioid overdose. Through LDH’s efforts, naloxone is covered by the state’s Medicaid program, and participating pharmacists can dispense it to residents without a formal prescription. Having this medication readily available truly saves lives. The Louisiana Board of Pharmacy has also adopted regulations requiring all phy- sicians and other healthcare professionals licensed through the Board to prescribe opioids to complete a minimum of three hours of approved continuing medical education. This training must cover best practices for opioid prescribing, drug di- version, addiction treatment and/or ap- propriate treatment of chronic pain. The Role of Medicaid Louisiana’s Medicaid Expansion in 2016 has provided healthcare coverage to more than 500,000 working poor and non-el- derly adults thus far. By this summer, ap- proximately 37 percent of the population was expected to be enrolled in Medicaid. According to the Kaiser Family Founda- tion (KFF) 1 , in Louisiana, less than 500 per 100,000 Medicaid enrollees suffer from opioid addiction. For those who do, the availability of Medicaid coverage provides increased access to a broad range of ad- diction treatment services, including inpa- tient detoxification, outpatient treatment, and medication-assisted treatment. In addition, those who suffer from opi- oid addiction often have other health needs related to substance misuse. These include hypertension, mental illness- es and heart conditions, among others, which may ultimately contribute to higher healthcare costs as healthcare utilization rates tend to be higher among this popula- tion. Through Medicaid, these individuals receive integrated care management ser- vices in coordination with their physicians, substance abuse treatment providers, and social service programs. One Medicaid Plan’s Response Withmore than 450,000members and a network of over 21,000 healthcare provid- ers statewide, Louisiana Healthcare Con- nections has long recognized the impact of addiction on families and outcomes, and has responded with an integrated strate- gy centered on advancing evidence-based care. The centerpiece of this strategy is sup- port for physicians through clinical train- ing in evidence-based practices. In 2018, more than 253 continuing education cred- its were awarded to providers across the state in substance use and addictive disor- ders, and more recently, Louisiana Health- care Connections began offering a free clinical training series to help physicians become buprenorphine-waivered to treat opioid use disorder. Buprenorphine offers great potential for expanding treatment and has been prov- en to be a clinically effective therapy for pregnant women. 2 The course, conducted by theAmerican Society of Addiction Med- icine (ASAM), provides physicians with CME credits, a copy of the ASAM National Practice Guidelines and other clinical re- sources. Registration for the course may be completed online at www.Louisiana- HealthConnect.com/ASAMtraining. With these investments in patients and providers, the increased awareness across the state, and the availability of evidence-based training resources, Loui- siana’s ability to prevent and treat addic- tion will improve. And it is imperative that Louisiana payers, providers, and officials continue to work collaboratively to curb opioid addiction; many of our citizens’ lives depend on our collective success. n References 1 Katherine Young and Julia Zur. (2017) “Medicaid and the Opioid Epidemic: Enrollment, Spending, and the Implications of Proposed Policy Changes.” Henry J. Kaiser Family Foundation Issue Brief. 2 Osama M. Ahmed, Jodi A. Mao, Stephen R. Holt, Kathryn Hawk, Gail D’Onofrio, Shara Martel, Edward R. Melnick. (2019) A scalable, automated warm handoff from the emergency department to community sites offering continued medication for opioid use disorder: Lessons learned from the EMBED trial stakeholders. Journal of Substance Abuse Treatment 102, 47-52.