Cigna Creates Online Initiative To Drive Patient-Provider Conversations Regarding Pain and Opioid Prescriptions Interview with:

Dr. Stuart Lustig, M.D., M.P.H National Medical Executive for Behavioral Health Cigna

Dr. Lustig

Dr. Stuart Lustig, M.D., M.P.H
National Medical Executive for Behavioral Health

Dr. Lustig discusses Cigna’s efforts to curb the opioid epidemic. What is the background for the Applying American Society of Addiction Medicine Performance Measures in Commercial Health Insurance and Services Data study?

Response: In 2016 Cigna announced a collaboration with the American Society of Addiction Medicine (ASAM) to improve treatment for people suffering from substance use disorders and establish performance measures and best practices for addiction treatment. Mining anonymized data from Cigna’s administrative data, Brandeis University researchers have validated a new way to hone in on trouble spots where substance use disorder treatment for opioid, alcohol and other drug dependence is suboptimal, like the way police departments use computers to identify high crime areas in need of greater scrutiny and attention.

The technique uses ASAM-defined performance measures to assess substance use disorder treatment patterns, giving researchers the ability to sort through administrative data and measure to the extent to which patients being treated for opioid or alcohol use disorder are receiving and using evidenced-based medications proven to be effective in improving outcomes and retention in treatment. It also measures whether those patients received support during substance withdrawal – a critical factor in the success of addiction treatment plans. The performance measures were first tested on the Veterans’ Health Administration in 2016 and now, on data from Cigna. What are the main findings?

Response: The study revealed that ASAM’s performance measures to assess the Standards of Care for the Addiction Specialist for appropriate care for the treatment of substance use disorders are highly adaptable and feasible within commercial health service companies like Cigna. Its success in both settings show that ASAM specifications may be a universally valuable tool in increasing treatment compliance and effectiveness in private and governmental health care settings.

With a marked rise in drug overdoses, constant changes to healthcare coding systems, new formulations of current medications, and new payment approaches such as bundled payment, it is critical to have a flexible and reliable approach to measuring  access to, and the appropriateness and effectiveness of substance use disorder  treatment. Would you describe the 1 in 5 initiative? How can patients and providers benefit from this resource?

Response: Cigna’s new, online initiative aims to address the reality that one in five people are at increased risk of long-term opioid use with just a 10-day prescription. Many people think that opioid addiction won’t impact them, but it doesn’t discriminate. Cigna is empowering patients to have an informed conversation about pain and pain management with their health care provider before an opioid prescription is written – and getting a Pain Plan in place.

To create a pain plan, we’re encouraging people to text “help with pain” to 25792. They will then receive a list of questions you can ask your health care provider, along with a link to other helpful resources available on The website has tools for individuals, care providers and employers to help prevent opioid misuse through education. Our hope is that these tools serve as a resource to begin an informed conversation between patients and their health care provider and develop a highly personalized pain plan together. What should readers take away from your report? 

Response: Both acute and chronic pain can be debilitating, and we understand the real challenges people face when trying to cope with their pain. But there is also the reality that opioid addiction doesn’t discriminate.

Creating a pain plan with a health care provider will help patients better understand available treatments, including behavioral, pharmaceutical and medical options, provide guidance for the safe and appropriate use of opioids, and set goals for pain relief.

We want to help everyone better understand pain, how it manifests, and ultimately, how to manage it safely and effectively, immediately and over time.

Cigna is dedicated to helping people improve their well-being and sense of security. Preventive care like this is so important to us because we are committed to helping people take proactive control of their health and live healthy, productive lives. Is there anything else you would like to add? 

Margaret A. E. Jarvis, MD, DFASAM,  Vice-president of the American Society of Addiction Medicine (ASAM): ASAM’s strategic collaboration with Cigna does an invaluable service to addiction practices by demonstrating the real-world application of performance measures, which aim to improve an addiction patient’s health, promote research-validated, results-based, cost-efficient health care, and ensure the delivery of standards of care. Cigna’s support of these efforts by providing a data-set continues ASAM’s decades of research and development to improve the quality and access to addiction care.

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Last Updated on May 23, 2018 by Marie Benz MD FAAD