Reduce Opioid-Driven Healthcare Costs Before They Escalate
Opioid dependency creates a hidden cost driver that traditional analytics miss. We identify the risk before it becomes a liability.
The Financial Impact You Don't See
These costs often appear as general medical trend increases, not “opioid” line items. By the time addiction indicators surface, costs have already escalated.
1 in 3
Complications
Members prescribed an opioid who may develop dependency-related complications.
3X
Encounters
Dependent members have up to 3X more healthcare encounters than average.
7X
Cost Impact
High-risk opioid members can be up to 7X more expensive to the health plan.
See Your Risk Exposure Clearly
Traditional tools identify risk after the cost has occurred. OpioidRx fills that clinical gap with predictive reporting.
- Retrospective Risk Analysis (No PHI)
- Provider Prescribing Profiles
- Estimated Cost Impact
- Measurable Reduction Opportunities
“You receive measurable outcomes, not assumptions.”
How the Program Works
Implementation can begin within weeks using existing claims data. No new software integration required.
1
Retrospective Analysis
We analyze blinded pharmacy claims using AI to detect early clinical indicators. No PHI required. No disruption.
2
Prescriber Engagement
We engage providers identified by risky patterns, supporting adoption of CDC-aligned tapering practices.
3
Monitoring & Reporting
Quarterly reporting measures reductions in high-risk prescribing, medical encounters, and cost impact.
Zero Administrative Burden
Launching a new health initiative shouldn't require months of IT integration. OpioidRx requires no new software, no PHI, and no disruption to your existing plan.
Measurable Results for Counties
Results are tracked using prescriptions per 100 residents and claims-based methodologies.
75%
Reduction in high-risk
opioid prescriptions
56%
Reduction in cost per
high-risk member
41%
Reduction in ER
visits & hospitalizations
99%
Provider adoption of
CDC standards
Proven Financial & Clinical Outcomes
See how self-insured plans are using AI-driven clinical insights to reduce high-risk prescriptions and eliminate millions in avoidable medical spend.
Association Health Plan
A 6,000-member plan utilized OpioidRx-AI to reduce their high-risk opioid population by 80%, resulting in an 88% reduction in health plan cost per member.
Read Case StudyThird Party Administrator
By identifying underlying clinical risk rather than relying solely on PBM analytics, this 10,000-member plan reduced high-risk opioid prescriptions by 75%.
Read Case StudyFlorida School District
OpioidRx pharmacists successfully educated the provider network, driving a 98% adoption of CDC guidelines and reducing related hospitalizations by 39%.
Read Case StudyIdeal For
- Self-insured employers (250+ employees)
- Organizations with rising medical trends
- Plans looking for defensible ROI
- Brokers seeking differentiated value
What We DON'T Do
We reduce risk without creating friction for your employees.
- We do NOT restrict appropriate access to pain management.
- We do NOT remove physicians from decision-making.
- We do NOT create friction for members.
Start With a Free Opioid Exposure Analysis
We begin with a no-cost retrospective analysis of your paid pharmacy claims. No obligation. No PHI required.