In 2016, West Virginia was identified by the Centers for Disease Control and Prevention as the state with the highest rate of death due to drug overdose. Pennsylvania was fourth.

Highmark is working to minimize the impact of opioid misuse by giving physicians the tools and resources to make better decisions about pain management and pain medication. By joining forces with axialHealthcare, a national leader on safe and effective pain management and opioid therapy, Highmark is committed to providing the best resources to ensure the health and safety of our members.

Initiated in West Virginia and now expanding to Pennsylvania, this initiative gives physicians insight on their opioid prescribing patterns. axialHealthcare’s resources provide a more comprehensive view of a patient’s medication use in order to reduce the risks associated with opioid therapy, such as multi-prescriber activity, adverse drug interactions, overdose, and addiction.

The Pain Management Program portal offers these resources and more to support decisions about treatment options for patients using opioids. The portal includes individual patient alerts for those at risk for poor outcomes, care pathways for common pain complaints, and the latest clinical guidelines around opioid prescribing. Patient alerts also may appear on NaviNet^® during eligibility checks when an appointment is scheduled.

To access the portal:

• Use Auth Inquiry and Reports in Highmark NaviNet.
• Select Pain Management Program Portal.
• Select the appropriate Billing Provider and Service Provider and click Submit.
• From the axialPRACTICE Dashboard, you can access your monthly Risk Identification and Mitigation (RIM) Score, Patient Alerts, Care Pathways, a Risk Informed Surgical Evaluation tool, and other resources to care for patients in pain.

The RIM Score is comprised of 15 evidence-based quality metrics proven to impact patient safety and quality of care around opioid prescribing. A provider’s score is an assessment of opioid prescribing patterns compared to his/her specialty peer group, and the RIM Score shown in NaviNet is for the most recent one-month period.*

Watch Provider News for updates about the Highmark-axialHealthcare Pain Management Program.

*The metrics that make up the RIM Score all have different look-back periods, but the score itself is calculated monthly.