CCA Shows Success in Managing Members’ Pain and Opioid Use

The United States is battling an opioid crisis, and it is critically important that healthcare organizations do what they can to identify patients at high risk of suffering from the negative effects of this form of pain management. One organization addressing this issue is Commonwealth Care Alliance (CCA), a not-for-profit healthcare organization that serves more than 32,000 low-income, disabled, and elderly patients across Massachusetts who are dually eligible for Medicare and Medicaid. These individuals are often referred to as “super-users” of the healthcare system, as they make up only 5% of the population but account for about half of healthcare spending. Because of their complex patient profile, 20% of CCA members take opioid medications—a number much greater than the general population. This high rate, combined with the inherent challenges associated with managing pain and care with opioids, led to the creation of CCA’s statewide High Opioid Patient Engagement (HOPE) program, which manages the risk of overdose and reduced opioid dependence among members.