Center for Mental Health, University of Pennsylvania, 3535 Market St, 3rd Fl, Rm 3087, Philadelphia, PA 19104. Email:
Am J Manag Care. 2021 Dec 1;27(12):e429-e434. doi: 10.37765/ajmc.2021.88798.
Philadelphia, Pennsylvania, is an urban epicenter of the opioid epidemic, and inappropriate opioid prescribing remains a top concern. To help address this issue, the Philadelphia Medicaid Opioid Prescribing Initiative, a type of community quality collaborative, mailed thousands of local Medicaid providers an individualized prescribing report card in 2017 and 2018. The report card featured details of providers' opioid prescribing, including peer comparison measures and inappropriate prescribing measures like concomitant opioid and benzodiazepine prescribing. This case study describes the unique process of developing and distributing the opioid prescribing report cards, with a particular focus on the role of Medicaid managed care organizations. Using Medicaid pharmacy claims, the extensive variation in prescribing measures within and across specialties is also illustrated. The report card's implementation points to the potential value of collaborations between public health departments and Medicaid managed care organizations and can provide insight for other locally grown policies.
宾夕法尼亚州费城是阿片类药物流行的城市中心，不适当的阿片类药物处方仍然是一个主要关注点。为了解决这个问题，费城医疗补助阿片类药物处方倡议，一种社区质量合作组织，于 2017 年和 2018 年向数千名当地医疗补助提供者邮寄了个人处方报告卡。报告卡详细说明了提供者的阿片类药物处方情况，包括同行比较措施和不适当的处方措施，如同时开阿片类药物和苯二氮䓬类药物。本案例研究描述了制定和分发阿片类药物处方报告卡的独特过程，特别强调了医疗补助管理式医疗组织的作用。使用医疗补助药房索赔数据，还说明了各专业内部和专业之间处方措施的巨大差异。报告卡的实施表明公共卫生部门和医疗补助管理式医疗组织之间合作的潜在价值，并为其他本地政策提供了参考。
