The opioid crisis has put a spotlight on physician prescribing practices, especially since studies show a quarter of chronic pain patients misuse opioids. One startup in Nashville has become a sort of watchdog for health insurers who spend far more when a patient is abusing opioids.
“It’s billions of dollars in amenable, avoidable health care expenses associated with poor treatment,” said John Donahue, CEO of Axial Healthcare.
Physicians who seem to be over-prescribing painkillers or working with addicted patients may now get a tap on the shoulder from Axial, which has contracts with big insurers in high opioid abuse states like Tennessee, Alabama, Pennsylvania and West Virginia.
The company has a trove of claims data on 100 million patients. Sophisticated algorithms identify problem prescribers and even patients at risk of overdose, suicide or having a baby born in withdrawal.
“In fairness to the practitioners, they just do not know what they don’t know,” Donahue said.