In this section we share examples of health plans’ online resources for members and a toolkit for patients and family members.
How to Do It
- Identify at-risk member needs, for example:
- Member is experiencing pain
- Member is concerned about mental health issues
- Member is concerned about substance use disorder (SUD)
- Member or family is concerned about overdose
- Develop and make available resources for members.
- Train member services to recognize and respond appropriately.
Health Plan Stories
Kaiser Permanente Southern California
At one point, a large number of member complaints were from opioid-seeking patients.
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At one point, a large number of member complaints were from opioid-seeking patients. Kaiser Permanente Southern California (KPSC) recognized the need for member services and physicians to respond appropriately and consistently when members called or presented requesting a new opioid prescription or a renewal of an existing or expired prescription. KPSC developed a guide for member services representatives to help them address members’ concerns and direct them to the appropriate prescriber for follow-up. It also trained physicians to respond to requests with alternative solutions rather than simply denying members’ requests.
Partnership HealthPlan of California
Partnership HealthPlan of California trained member services staff to liaise with the Outreach and Understanding Can Help (OUCH) case management team. Member services representatives would listen for buzzwords (e.g., opioid, Vicodin, overdose, withdrawal) indicating a member was struggling with opioid use disorder. When member services encountered such members, they would refer the members to the OUCH team, and a case manager would handle the members’ requests and coordinate follow-up.
Tools
Member Resources
Patients and their families seek information from a wide variety of sources. Use this tool to explore resources that are available to them.
Download this tool: Member Resources (PDF).
Other Tools
- American Society of Addiction Medicine: Opioid Addiction Treatment: A Guide for Patients, Families, and Friends (PDF)
- Centers for Disease Control and Prevention: Opioid Overdose: Information for Patients
- Department of Veterans Affairs: Patient Information: Taking Opioids Responsibly (PDF)
- Food and Drug Administration: What to Ask Your Doctor Before Taking Opioids
Resources
- American Addiction Centers: Addiction Treatment Helpline
- Partnership HealthPlan of California: Managing Pain Safely
- Prescribe to Prevent: Videos for patients
- San Francisco Department of Public Health: Opioid Safety and How to Use Naloxone: A Guide for Patients and Caregivers (PDF)
- Substance Abuse and Mental Health Services Administration: National Helpline and Addiction Treatment Locator