- Safe opioid prescribing policies cut the share of Medicare recipients who got higher-than-recommended doses from multiple doctors by 40% in 2017, according to a just-released “roadmap” on how CMS is addressing the nationwide epidemic.
- All CMS programs — Medicare, Medicaid and Affordable Care Act insurance exchanges — currently offer some form of medication-assisted treatment for opioid use disorder. And as of this month, the agency has approved 12 state Medicaid demonstrations aimed at improving access to treatment of the disorder, including new options for inpatient and residential treatment.
- Looking forward, CMS plans to expand patients’ choices of treatment options, including non-opioid treatments for pain. The roadmap also calls for greater data transparency and interoperability and use of a Medicare heat map to pinpoint areas that can benefit from targeted safe prescribing efforts.
To fight the opioid crisis, CMS sent 24,000 letters to Medicare doctors this year and last, pointing out that their rate of opioid prescriptions outpaced their peers. The agency also engaged 4,000 hospitals, 120,000 clinicians and 5,000 outpatient settings to generate best practices in reducing opioid-related misuse and abuse.
More than 42,000 Americans died as a result of opioid use in 2016, or 116 people a day. Of those, 40% involved a prescription opioid.
While overprescribing is an important piece of the opioid crisis, a study this spring in the American Journal of Public Health found that social and economic hardship also plays a role. Housing insecurity, for example, can trigger negative behaviors that undermine physical and mental health. Opioid overdose is a major cause of death among the homeless.
Other goals in the blueprint include incorporating incentives for appropriate prescribing into future Medicare quality star ratings and the Quality Payment Program and aligning monitoring of overprescribing with Centers for Disease Control and Prevention guidelines and law enforcement efforts.
In addition, it calls for a "new authority to limit Medicare beneficiaries to certain pharmacies and doctors" and improving real-time prescription controls using prescription databases.
President Donald Trump’s administration recently rolled out plans to tackle the opioid crisis, including development of new non-addictive pain treatments and a public-private initiative to create a vaccine to prevent opioid addiction.
Last month, the Food and Drug Administration announced an “innovation challenge” to encourage development of digital health apps and other tools aimed at preventing, detecting and treating opioid addiction. Both the House and Senate are also moving major opioid bills aimed at addressing the crisis.