News & Commentary

Health insurance costs from opioid epidemic soar


Frank Diamond

Human toll from the opioid epidemic is horrendous, but it also has a significant economic cost, and the insurance industry is feeling those effects. Professional charges for opioid abuse and dependence were 10 times higher in 2015 than in 2011 ($721.8 million vs. $71.7 million), according to a white paper by FAIR Health, a not-for-profit organization in New York City that analyzes and investigates insurance payments. Allowed amounts climbed even faster and were 13 times higher last year than in 2011 ($445.7 million vs. $32.4 million). By FAIR Health’s calculation, the average allowed amount for opioid patients was $19,333 in 2015. For all others, the per-patient allowed amount was $3,435.

Dependence, abuse leads to tsunami of medical services

Source: FAIR Health, “The Impact of the Opioid Crisis on the Healthcare System,” September 2016

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