Evaluation of a Medicaid performance improvement project to reduce high-dose opioid prescriptions

In 2015, Oregon's Medicaid program implemented a performance improvement project to reduce high-dose opioid prescribing across its 16 coordinated care organizations (CCOs). The objective of this study was to evaluate the effect of that program on prescription opioid use and outcomes. Using Medi...

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Bibliographic Details
Published in:BMC health services research 2022-01, Vol.22 (1), p.68-68, Article 68
Main Authors: Hartung, Daniel M, Geddes, Jonah, Hallvik, Sara E, Korthuis, P Todd, Middleton, Luke, Leichtling, Gillian, Hildebran, Christi, Kim, Hyunjee
Format: Article
Language:English
Subjects:
Analgesics, Opioid - adverse effects
Distribution
Dosage and administration
Drug dosages
Drug overdose
Drug Prescriptions
Evaluation
Forecasts and trends
Health services
Heroin
Humans
Intervention
Medicaid
Morphine
Narcotics
Opioid Epidemic
Opioids
Overdose
Pharmacy
Practice Patterns, Physicians
Prescription drugs
Prescriptions
Public health
Rural areas
Services
Trends
United States - epidemiology
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Summary:In 2015, Oregon's Medicaid program implemented a performance improvement project to reduce high-dose opioid prescribing across its 16 coordinated care organizations (CCOs). The objective of this study was to evaluate the effect of that program on prescription opioid use and outcomes. Using Medicaid claims data from 2014 to 2017, we conducted interrupted time-series analyses to examine changes in the prescription opioid use and overdose rates before (July 2014 to June 2015) and after (January 2016 to December 2017) implementation of Oregon's high-dose policy initiative (July 2015 to December 2015). Prescribing outcomes were: 1) total opioid prescriptions 2) high-dose [> 90 morphine milligram equivalents per day] opioid prescriptions, and 3) proportion of opioid prescriptions that were high-dose. Opioid overdose outcomes included emergency department visits or hospitalizations that involved an opioid-related poisoning (total, heroin-involved, non-heroin involved). Analyses were performed at the state and CCO level. There was an immediate reduction in high dose opioid prescriptions after the program was implemented (- 1.55 prescription per 1000 enrollee; 95% CI - 2.26 to - 0.84; p 
ISSN:1472-6963
1472-6963
DOI:10.1186/s12913-022-07477-6