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New DHS system will monitor doctors prescribing too many opioids to Medicaid, MinnesotaCare patients

Healthcare providers will be put on improvement programs if they're giving out too many.
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Correction: An earlier version of this story said that the new opioid reporting measure includes "opioids prescribed to patients in inpatient settings, those with cancer, and those receiving hospice services," but we should actually have said excludes. We apologize for the error.

Health providers found to be prescribing too many opioids to Medicaid and MinnesotaCare patients in Minnesota will be subject to a state-monitored "quality improvement program."

The announcement from the Minnesota Department of Human Services (DHS) says that more than 16,000 health care providers serving residents who receive state-subsidized healthcare will receive reports in the coming weeks comparing how many opioids they're prescribing compared to their peers.

It comes as the DHS found that the amount of opioid prescriptions in Minnesota counties ranged from 27.4 per 100 residents to 98.6 in 2017.

In the same year, 401 opioid deaths were reported in Minnesota, of which 188 were linked to prescription opioids and methadone.

More than a quarter of healthcare providers serving MinnesotaCare and Medicaid patients in Minnesota who wrote at least 10 opioids last year are above what the DHS calls its "quality improvement threshold" for at least one of seven measures it uses to assess excessive opioid distribution.

These measures exclude opioids prescribed to patients in inpatient settings, those with cancer, and those receiving hospice services.

After the first set of opioid reports has been issued, healthcare providers – which includes medical doctors, dentists and nurse practitioners – will be given the opportunity to improve their practices.

If they haven't improved sufficiently by the time the second set of reports are issued, they will be required to undergo a quality improvement program monitored by the DHS starting in 2020.

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If the health providers continue to not meet the quality standards set by the DHS and are carrying out prescribing processes that is considered unsafe, they could face being removed from the Medicaid program in 2021.

"The need to improve opioid prescribing behavior and reduce overprescribing is demonstrated in the wide variation in the state’s opioid prescribing rates, which cannot be fully explained by differences in patient demographics or geography," the DHS said.

Such variation includes the aforementioned disparity in opioid prescribing rates by county, but also the fact that the top-quartile of emergency physicians prescribe opioids at a rate 2.8 times above the median.

In family medicine, the top quartile prescribe opioids at a rate 3.8 times higher than the median.

"DHS is committed to these quality improvement efforts and will work closely with health care professionals to ensure safe, appropriate opioid prescribing in Minnesota," said DHS Commissioner Tony Lourey.

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