Overcoming red tape to address the opioid crisis

Close-up photo of buprenorphine description with chemical equation symbols
June 8, 2018
Camden Coalition staff and Community Advisory Committee members participate at the Housing and Community Development Network of New Jersey’s Annual Legislative Day at New Jersey State House
July 18, 2019
Camden Coalition joins the call to fully fund the Affordable Housing Trust Fund
To help secure FY2020 funding for the Affordable Housing Trust Fund, CAC members took part in HCDNNJ's Annual Legislative Day at the NJ State House.
Whitney Buchmann
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In this four-part series, we describe the phases of our care model as we addressed challenges and tested new solutions.
Kathleen Noonan and Kelly Craig
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Graduates of Interfaith Homeless Outreach Council program reflect on their fresh start
Now in its 28th year, the Interfaith Homeless Outreach Council — or IHOC — has transformed countless lives.
Bill Nice
Camden Coalition care team member helps patient fill medication box.
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Bringing it home: The shift in where healthcare is delivered
In this blog post for JAMA Forum, Lauran Hardin and Diana Mason write about two new opportunities to incentivize innovative complex care models.
Lauran Hardin and Diana Mason
Patient gives Camden Coalition care team member a hug during a home visit
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New Jersey FY 2020 budget renews support for Camden Coalition’s Housing First program and officially recognizes organization as Regional Health Hub
New Jersey leaders have taken an important step toward better health outcomes across the state.
Kathleen Noonan
Kathleen Noonan speaking to graduates in caps and gowns
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Bridging the public health-healthcare divide for better outcomes
The public health field has an opportunity right now to influence the traditional healthcare model in ways it has not in a very long time.
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By Natasha Dravid

The opioid crisis is driving government, healthcare providers, and health insurance companies to find new solutions and pathways for faster treatment. For example, in March, Pennsylvania Governor Tom Wolf waived prior authorization for buprenorphine, a medication-assisted treatment for opioid addiction often known by the brand name Suboxone. New Jersey Governor Chris Christie also waived prior authorization for buprenorphine, but his policy did not apply to people on Medicaid. The good news is that, as we wait for states to implement legislative or administrative solutions to this critical issue, we are piloting innovative solutions to improve access for patients.

In South Jersey, a joint initiative of the Addiction Medicine Program at Cooper Hospital; Project H.O.P.E., a federally qualified health clinic; a leading health insurance company; and the Camden Coalition of Healthcare Providers has activated a pilot program that issues a “gold card” for our partners to skip the prior authorization process and expedite our patients’ access to buprenorphine.

Prior authorization is an administrative process insurance companies require of doctors before they may prescribe buprenorphine. Waiving prior authorization means that doctors can prescribe this often life-saving medication without submitting paperwork and seeking permission.

Buprenorphine helps patients fight opioid addiction by reducing withdrawal symptoms. Unlike other prescription drugs to treat opioid addiction, buprenorphine requires neither a daily trip to a clinic, nor a full detox in order to initiate. Quicker access to treatments like buprenorphine can translate into saved lives.

Why is prior authorization a problem? Prior authorization can delay access to treatment by over a week. During this delay, individuals motivated enough to connect with outpatient treatment — sometimes after a catalytic moment such as an overdose, discharge from jail, or following a medical complication from injection drug use — are forced to wait for a medication that prevents the symptoms of withdrawal and enables relief from addiction. This is exactly the wrong time to postpone treatment.

Together with experts like Dr. Lynda Bascelli at Project H.O.P.E. and Dr. Kaitlan Baston at Cooper Addiction Medicine, we have helped patients with complex health and social needs recover from opioid addiction through multiple programs. Dr. Baston referred Christine to our Camden Delivers pilot for women fighting addiction while pregnant, and we were able to help her secure housing and support. Working with Dr. Bascelli, our care management team is helping Charlie get back on track after a life on and off heroin and in and out of jail. Charlie and Christine are both doing well today and following their care plans with the help of medication-assisted treatment. Christine’s one-year old son is walking and learning to talk.

The vision for the Suboxone Gold Card program is that the disciplined teamwork between the insurance company and the providers on the ground will lead to a scalable, replicable program that allows the insurer to waive the prior authorization for any buprenorphine prescriber who meets a one-time set of criteria. Of course, a gold card program alone will not fix the opioid crisis. Truly addressing the problem will take much more than that. However, finding new ways for healthcare providers and health insurance companies to work alongside — and not against — each other will be an important part of the solution.

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