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Fighting addiction with data: how focusing on physician quality and practice patterns can impact America's opioid epidemic
Upper Lobby
Fighting addiction with data: how focusing on physician quality and practice patterns can impact America's opioid epidemic
Opioid use disorder (OUD — the medical term for addiction to opioid substances such as prescription painkillers or heroin) is an increasingly alarming epidemic. Overdoses involving opioids killed 28,647... Read more

Description

Opioid use disorder (OUD — the medical term for addiction to opioid substances such as prescription painkillers or heroin) is an increasingly alarming epidemic. Overdoses involving opioids killed 28,647 Americans in 2014, and the rate of opioid overdose has tripled since 2000. Recent studies estimate that 2.4 million Americans meet criteria for OUD and many more use opioids recreationally, putting themselves at significant risk for addiction, overdose, and related morbidities. In addition to its devastating consequences to individuals, OUD is estimated to have a societal cost of $55.7 billion annually.

Although the root causes of America’s opioid epidemic are multifaceted, physician behavior and practice patterns play a significant role. Consider that Americans consume 80% of the global supply of all opioids despite comprising less than 5% of the global population, and the vast majority of these opioids are prescribed.

Once a problem concentrated in America’s urban-poor population, OUD has spread to all corners of American society and currently exerts a significant toll on the middle class and the actively employed population. The demographic shift poses a significant threat to the productivity of the American economy: Opioid usage (by prescription or otherwise) is associated with decreased employment, increased healthcare utilization, poor workers’ compensation claim outcomes, increased rates of disability, decreased rates of return-to-work following injury, and decreased self-reported ratings of quality of life and overall health.

Findings:

American employers, insurers, and payers have an opportunity to address the opioid epidemic by influencing patient and physician behaviors. Specifically, by encouraging and rewarding patient visits to high quality physicians who demonstrate responsible opioid prescription patterns. By identifying, rewarding, and spreading the best-practices of high-quality physicians, Grand Rounds promotes primary prevention of the OUD epidemic within the covered populations of our customers and partners. We agree with experts in the field that prioritizing a primary prevention strategy is key to combating the opioid epidemic, especially given the unique features of OUD that make secondary prevention strategies particularly difficult and resource intensive.

Through our unique approach to data analytics and physician quality, Grand Rounds has identified significant regional variation in opioid prescription patterns within specialties. Furthermore, this variation can be predicted by our assessments of physician quality. Focusing specifically on the specialties of pain management, orthopedics, and primary care (the three highest opioid prescribing specialties) we find significant variation in the use of evidence-based, multidisciplinary treatments for chronic pain, which can be predicted by our assessments of physician quality.

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