ACOs Preventing Opioid Overuse

February 05, 2018

The Medicare population has among the highest and fastest-growing rates of diagnosed opioid use disorder, at more than 6 out of every 1,000 beneficiaries.

Current prescribing practices along with the high potential for opioid abuse have led to record numbers of opioid use disorders, overdoses, and deaths. In 2009, deaths from drug overdose, including heroin and prescription opioids, surpassed motor vehicle crashes as the leading cause of death in the U.S., and numbers continue to rise. The U.S. Surgeon General recently alerted health care practitioners to the scope of the problem and urged them to visit TurnTheTideRx.org to join the movement to address the opioid epidemic.

The Medicare population has among the highest and fastest-growing rates of diagnosed opioid use disorder, at more than 6 out of every 1,000 beneficiaries. In response, CMS launched the CMS Opioid Misuse Strategy in March 2015 to address the devastating epidemic of opioid misuse among Medicare beneficiaries and their families. This ongoing strategy offers providers resources to combat misuse and promotes programs that support treatment and recovery.
Responding to the opioid epidemic depends upon the collective efforts of community physicians (including those in ACOs), health insurance providers, and states’ policy makers. Such stakeholders must focus on improving prescribing practices, diagnosing opioid use disorder, and connecting patients to treatment.

Some resources and information to assist in these efforts include:

The CDC Guideline for Prescribing Opioids for Chronic Pain reviews the CDC’s approach to opioid prescriptions and use of claim data to conduct analyses. https://www.cdc.gov/opioids/healthcare-professionals/prescribing/guideline/index.html
The Surgeon General’s report on Substance Use and Addiction, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health reviews what we know about substance misuse and how this knowledge can be used to address substance misuse and related consequences. https://addiction.surgeongeneral.gov/
The CMS Opioid Misuse Strategy outlines the CMS strategy goals and priorities to reduce opioid overdoses and the prevalence of opioid use disorders. https://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/Downloads/CMS-Opioid-Misuse-Strategy-2016.pdf
The Medicare Part D Opioid Prescribing Mapping Tool is an interactive tool that helps others better understand how this critical issue impacts local communities. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/OpioidMap.html
The Turn the Tide Rx Campaign which focuses on educating and mobilizing prescribers to take action to end the opioid epidemic by improving prescribing practices, informing patients about the risks of and resources for opioid addiction, and encouraging health care professionals to take a pledge to end the opioid crisis.

CMS encourages ACOs to engage in this national effort and provide their ACO participants with these resources to aid in reducing opioid overuse.