PQA Measure of Use of Opioids at High Dosage in Persons Without Cancer Included in Medicaid Adult Core Set of Measures for 2016

The PQA has announced that the PQA-endorsed measure, Use of Opioids at High Dosage in Persons Without Cancer, has been included in the Medicaid Adult Core Set of Measures for federal fiscal year 2016.

PRESS RELEASE

Springfield, Va. (July 12, 2016) — The Pharmacy Quality Alliance (PQA) announced today that the PQA-endorsed measure, Use of Opioids at High Dosage in Persons Without Cancer, has been included in the Medicaid Adult Core Set of Measures for federal fiscal year 2016 reporting. The CMS Medicaid Adult Core Set of Measures was established as a way to standardize the measurement of healthcare quality across state Medicaid programs. The Adult Core Set includes 28 measures that help evaluate quality care and facilitate quality improvement related to prevention, behavioral health and substance use, acute and chronic conditions, as well as other healthcare areas. Inclusion of the Use of Opioids at High Dosage in Persons Without Cancer measure in the Adult Core Set is another step forward on the path to combat the growing opioid epidemic.

Opioid overdose fatalities have become an epidemic in the last 20 years and a major public health concern in the United States. In 2014, more than 14,000 individuals died from overdoses involving prescription opioids. Reducing the number of unintentional overdoses has become a priority for PQA as well as numerous federal organizations including the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Federal Interagency Workgroup for Opioid Adverse Drug Events, and the Substance Abuse and Mental Health Services Administration.

The Use of Opioids at High Dosage in Persons Without Cancer measure calculates the proportion of individuals without cancer who are receiving very high daily dosages for an extended period of time. “People who receive high doses of opioids are more likely to die of drug overdoses. Stemming the tide of opioid overuse and resulting injuries and deaths will require a multi-pronged approach and the concerted efforts of each and every part of our health care system,” said Dr. Woody Eisenberg, Senior Vice President for Performance Measurement at PQA. “Performance measurement can be an important part of that multipronged approach and PQA is pleased that its health plan performance measure of Use of Opioids at High Dosage in Persons without Cancer has been added to the Medicaid Adult Core Set of Measures for 2016,” continued Eisenberg.

In addition, PQA has endorsed other measures of potential overuse of opioids, which focus on opioids obtained from multiple prescribers and multiple pharmacies. These have been implemented in the Medicare Part D Drug Benefit Overutilization Monitoring System. PQA is also in the process of developing opioid safety measures including concurrent use of prescription opioids and benzodiazepines, which when used together can be fatal. For more information, visit http://pqaalliance.org/measures/default.asp.