AHIP Releases Initial Benchmark To Measure And Improve Industrys Progress On Battling The Opioid Crisis

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February 7, 2018

Data is released as part of the industry’s Safe, Transparent Opioid Prescribing (STOP) Initiative

WASHINGTON, D.C. – America’s Health Insurance Plans (AHIP) released the first nationwide benchmark data that measures the health care industry’s progress in combatting the opioid crisis. This important baseline analysis shows the positive steps that clinicians and insurance providers have taken together – and identifies specific actions that can be taken to reduce addiction and abuse.

Using the methodology established by AHIP’s Safe, Transparent Opioid Prescribing (STOP) Initiative, this benchmark study shows how further collaboration across the industry will help to improve care for patients who experience pain, prevent opioid misuse, and reduce the risk of addiction.

“We can’t truly measure our progress until we know where we’re starting,” said Dr. Richard Bankowitz, Chief Medical Officer of AHIP. “These initial results will help ensure we’re making a meaningful and measurable impact as we work hand-in-hand with hospitals, physicians, patients and their families to stop this epidemic.”

The overall STOP initiative, announced in October 2017, was developed with the AHIP Opioid Work Group – consisting of more than 40insurance providers – to encourage widespread adoption of the Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain.

The STOP Measure methodology assesses performance for six of the twelve CDC recommendations. Using the methodology, AHIP analyzed health insurance claims data from 2009-2013 to create the industry’s initial baseline. The baseline will be used to measure the ongoing progress of the STOP initiative as insurance providers continue to collect and analyze their claims data.

“At Cigna, we’re committed to collaboration with our physician partners to safeguard against potentially inappropriate prescribing of opioids that could lead to addiction, while continuing to provide our customers with access to the right care at the right time,” said Dr. Dick Salmon, national medical officer, Cigna. “AHIP’s STOP Measure methodology and initiative gives health plans a roadmap toward accomplishing these important goals in our local communities.”

While the vast majority of opioid prescriptions for chronic pain were for immediate-release opioids, which is consistent with CDC recommendations, there are several critical measures that can be improved:

  • Approximately one quarter of opioid prescriptions are above the CDC-recommended morphine milligram equivalent (MME) dosage.
  • Only about 1 percent of patients underwent a urine drug test before being prescribed an opioid.
  • Nearly half of chronic pain patients also received benzodiazepine prescriptions during their opioid treatment. According to CDC guidelines, this can be unsafe for patients and should be avoided as much as possible.

The STOP Measure methodology has been shared with insurance providers nationwide, who may apply it to measure their own opioid prevention and management efforts. In the coming months, results from their assessments will be gathered and the AHIP Opioid Work Group will establish and share key learnings for tackling the opioid crisis.

A description of the methodology and baseline results can be found here. For more information about insurance provider strategies to address the opioid crisis, please visit http://www.ahip.org/wp-content/uploads/2018/02/AHIP_STOPPlaybook_2.1.18.pdf.

About AHIP

America’s Health Insurance Plans (AHIP) is the national association whose members provide coverage for health care and related services to millions of Americans every day. Through these offerings, we improve and protect the health and financial security of consumers, families, businesses, communities and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access and well-being for consumers. Visit www.ahip.org Learn more about health insurance and how it works at myhealthplan.guide.

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