MedImpact Reduces Opioid Overutilization by 36 Percent

In an announcement released Nov. 8, MedImpact revealed the success of the MedImpact Overutilization and Safety Controls Program addressing opioid overutilization. A three-year case study showcases the impact of clinical intervention in limiting potential opioid overuse and reduced overutilization.

The case study focused on the results of a program from April 2013 to October 2016 to better manage opioid prescription use. During the study, MedImpact identified more than 600 patients filling opioid prescriptions in excess of evidence-based guidelines. MedImpact conducted clinical interventions with prescribers that led to a 36-percent reduction of overutilization — saving plan sponsors unnecessary spending and providing better care for patients.

MedImpact’s Overutilization and Safety Controls Program

Starting April 2013, MedImpact performed monthly claims analysis to identify members with a cumulative daily Morphine Equivalent Dose (MED) exceeding 120 mg for at least 90 consecutive days. It also flagged patients with three or more prescribers and three or more pharmacies over a consecutive 90-day period.

MedImpact mailed intervention materials to more than 600 providers prescribing the highest volume of opioid — achieving an unprecedented 100-percent prescriber response rate. We identified 618 members potentially abusing opioids and worked closely with prescribers to conduct member-specific intervention to resolve overutilization and misuse.

Overutilization resolved outcomes included:

  • Reducing potential opioid overuse by 36 percent
  • Prescribers decreased dosage to ensure safe and appropriate opioid use
  • Members seeing multiple providers and/or pharmacies (per claims review)
  • Intervention assisted members in no longer meeting CMS overutilization criteria

By using actionable data to combat member opioid abuse, MedImpact has been able to save these clients potentially $6.35 million dollars in prescription and medical costs over the case study period.

The case study demonstrates MedImpact’s success in mitigating opioid overutilization and provides the detailed methods and results that helped provide cost savings and better care. Download the case study here.

View the press release here.

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