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NC Payers Council

In 2017, North Carolina launched a comprehensive Opioid Action Plan aimed at reducing opioid misuse, overdose and death. One of the strategies listed in the Opioid Action Plan is the creation of a Payers Council to identify and implement policies that reduce the oversupply of prescription opioids and improve access to substance use disorder treatment

In December 2017, the NC Department of Health and Human Services convened a Payers Council including public and private payers throughout the state to share best practices, align policies, and issue consensus recommendations. The Council included representatives from Medicare, Medicaid, Military and Veterans Administration, private insurers, pharmacy benefit managers, and workers’ compensation organizations. 

Payers and health plans can play a critical role in mitigating the consequences of the opioid epidemic through prevention and treatment. Payers have the ability to promote safer prescribing patterns through formulary structures and provider education, facilitate non-opioid approaches to pain management through benefit design, address substance use disorder treatment through coverage policies, educate beneficiaries on opioid risks through member services, and use data to develop and track programmatic and policy changes. 

The NC Payers Council developed consensus recommendations selected for their potential to positively impact the epidemic. Their report was released in September 2018.