Helping people RISE above substance use through proactive outreach
How Carelon is helping prevent severe substance use
Substance use disorder (SUD) likely touches each of us in some way — at home, in our workplaces, or in our communities. It’s a serious behavioral health condition that knows no boundaries of race, gender, education, or social class.
Nearly 48 million Americans aged 12 and older have SUD , according to Mental Health America 2024 data. People with SUD are unable to manage their use of legal or illegal substances like alcohol, cannabis, hallucinogens, hypnotics, inhalants, opioids, sedatives, stimulants, and even tobacco. The impact can be pervasive — leading to health complications, strained relationships, safety risks, and poor performance in school or at work.
RISE substance use disorder program
SUD is treatable, but because of the challenges mentioned above, effective treatment requires integrated care and support.
The Resilience through Intervention, Support, and Education (RISE) program from Carelon Behavioral Health is an innovative substance use disorder treatment program that helps manage and mitigate risks associated with SUD. As a field-based case management program, RISE aims to identify and support individuals who are at risk of developing severe alcohol or opioid-related health outcomes.
How the RISE program helps
The RISE program educates and empowers individuals to take an active role in preventing disorder progression and improving their overall health. This intervention can also help reduce healthcare costs.
To attain positive outcomes, RISE employs three elements:
- Predictive identification: Sophisticated algorithms identify individuals at high risk of SUD-related health issues within the next 12 months. This early identification allows for timely intervention.
- Proactive engagement: Once we identify individuals, a dedicated team of case managers and peer support specialists engages with them. This team acts as a single point of contact, providing resources, care coordination, and coaching.
- Comprehensive support: RISE serves members with comorbid physical and mental health conditions. Support services include telephonic care management, ensuring that individuals receive holistic support addressing their whole-health needs.
How effective is substance use treatment through RISE?
Since its launch in 2020, more than 2,000 individuals and providers have enrolled in RISE. “Our clinical outcomes have been very positive,” said Dheeraj Raina, MD, managing medical director of Carelon Behavioral Health. “Based on internal 2024 data, participants have recorded a significant improvement compared to a control group.”
These significant improvements in improving health outcomes and reducing healthcare costs include:
- 63% fewer inpatient admissions.
- 54% fewer emergency department visits.
- 39.5% fewer overdose incidents.
- 27.5% decrease in inpatient admissions with SUD diagnoses.
- Over $6 million in gross savings for the RISE group when compared to a control group.
Making a difference in people’s lives
Implementing a program like RISE can be transformative for those looking to offer substance use disorder services that enhance the health and well-being of their workplaces and communities. The program’s proactive engagement and support can help mitigate the progression of SUD, reduce associated healthcare costs, and improve quality of life.
