Editor’s Note: For payers and policy-makers it can be a challenge to design effective opioid crisis measures to control the rapid increase of overdoses as program effectiveness data is being accumulated. Staying abreast as to how opioid prescription control policies are evaluated for effectiveness, payers can be more efficient in their policymaking. Click HERE and discuss how BHM helps track claims data for payers. 

Efforts Against OpioidThe first nationwide benchmark study measuring the health care industry’s progress in combating the opioid crisis was released. This important baseline analysis shows the positive steps clinicians and insurance plans have taken together – and identifies specific actions that can be taken to reduce addiction and abuse.

This benchmark study shows how further collaboration across the industry will help to improve care for patients who experience pain, prevent opioid misuse, and reduce the risk of addiction.

Using the methodology established by AHIP’s Safe, Transparent Opioid Prescribing (STOP) Initiative, this benchmark study shows how further collaboration across the industry will help to improve care for patients who experience pain, prevent opioid misuse, and reduce the risk of addiction.

The STOP Measure methodology assesses performance for six of the twelve CDC recommendations. Using the methodology, AHIP analyzed health insurance claims data from 2009-2013 to create the industry’s initial baseline. The baseline will be used to measure the ongoing progress of the STOP initiative as insurance providers continue to collect and analyze their claims data.

While the vast majority of opioid prescriptions for chronic pain were for immediate-release opioids, which is consistent with CDC recommendations, there are several critical measures that can be improved:

  • Approximately one quarter of opioid prescriptions are above the CDC-recommended morphine milligram equivalent (MME) dosage.
  • Only about 1 percent of patients underwent a urine drug test before being prescribed an opioid.
  • Nearly half of chronic pain patients also received benzodiazepine prescriptions during their opioid treatment. According to CDC guidelines, this can be unsafe for patients and should be avoided as much as possible.

The STOP Measure methodology has been shared with insurance providers nationwide, who may apply it to measure their own opioid prevention and management efforts. In the coming months, results from their assessments will be gathered and the AHIP Opioid Work Group will establish and share key learnings for tackling the opioid crisis.

About AHIP

America’s Health Insurance Plans (AHIP) is the national association whose members provide coverage for health care and related services to millions of Americans every day. Through these offerings, we improve and protect the health and financial security of consumers, families, businesses, communities and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access and well-being for consumers. Visit www.ahip.org Learn more about health insurance and how it works at myhealthplan.guide.

For payers and policy-makers it can be a challenge to design effective opioid crisis measures to control the rapid increase of overdoses as program effectiveness data is being accumulated. Staying abreast as to how opioid prescription control policies are evaluated for effectiveness, payers can be more efficient in their policymaking. Click HERE and discuss how BHM helps track claims data for payers.