Chart of the Day: The Impact of Physician Feedback on Opioid Prescribing

Report Cards Associated With Reduced Prescribing

August 30, 2022

By:

Kaday Kamara

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Measures in the opioid prescribing report card were based on pharmacy claims from the baseline period (July 2016 to June 2017) and were mailed at the end of December 2017. The difference-in-differences estimation uses a six-month preperiod (July 2017 to December 2017 and a six-month postperiod (January 2018 to June 2018). These data are unadjusted for patients and provider characteristics.

Opioid overprescribing has been implicated in the opioid crisis. However, motivating physicians to change prescribing behavior has proven difficult. Performance feedback has been used in other medical settings to change behavior, does it work in the context of opioids?

In a recent study, LDI Senior Fellows Molly Candon and Aileen Rothbard, mailed opioid prescribing report cards to Medicaid providers in Philadelphia. The researchers then compared prescribing patterns to Medicaid providers in surrounding counties who did not receive report cards.

The authors found that there was a larger reduction in opioid prescribing among Philadelphia Medicaid providers than those in surrounding counties after report cards were mailed. In the six months after the report cards were mailed, compared with the six months before, each Philadelphia Medicaid provider prescribed three fewer Medicaid patients with an opioid prescription per month.

What do these findings suggest about the future impact of report cards in addressing opioid prescribing trends? Opioid prescribing report cards not only influence provider prescribing trends, but they also provide an opportunity for community collaboration. The report cards were developed by a multidisciplinary team of county officials, Medicaid managed care organizations, and academics, and were the first of their kind to be launched at the county-level, suggesting room for future collaboration. Additionally, report cards complement other interventions aimed at targeting inappropriate opioid prescribing, such as prescription drug monitoring programs and prior authorization.

The study, “The Impact of Opioid Prescribing Report Cards in Medicaid,” was published in the August 2022 issue of the Journal of Managed Care and Specialty Pharmacy. Authors include Molly Candon, Lingshu Xue, Siyuan Shen, Evan Cole, Julie Donohue, and Aileen Rothbard.