Controlled substances
Prime has been a leader on controlled substances misuse for more than a decade. Our program combines existing and new services to help address this national epidemic.
CS Score
Model reduces risk
Opioid misuse and over-prescription continues to be a major issue in the U.S. Our experience taught us that a multi-pronged model is the most effective way to fight this epidemic.
In addition to our current controlled substance efforts, we created a controlled substance management program. One of the highlights is a controlled substance score. It identifies people at risk of controlled substance misuse through predictive modeling.
The score is calculated by evaluating the:
- Number of unique controlled substance claims
- Total unique pharmacies and prescribers
- Utilization rate over time
This score then is used with our GuidedHealth® rules engine, which identifies drug therapy opportunities and encourages doctors to target and prioritize interventions.
More about our thought leadership
Stories
July 31, 2019
Prime showcases its controlled substance work at national conference
Pat Gleason and Jo-Ellen Abou Nader discuss the value of artificial intelligence using Prime’s integrated medical and pharmacy data
Perspectives, Stories
April 21, 2020
Driving Medicaid dollars to do more
Dedicated Medicaid teams drive value programming for Prime clients
Perspectives
June 15, 2018
Reducing opioid use among outliers; are we doing enough?
Prime helps health plans address members whose opioid use puts them outside the norm
Perspectives
November 30, 2017
Study of short-acting, long-acting and abuse-deterrent opioid use
The mix of opioids is crucial to the cost impact of abuse-deterrent opioids