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Use of Opioids at High Dosage in Persons Without Cancer

CBE ID
2940
Endorsed
New or Maintenance
Maintenance
Is Under Review
No
Measure Description

The proportion (XX out of 1,000) of individuals without cancer receiving prescriptions for opioids with a daily dosage greater than 120mg morphine equivalent dose (MED) for 90 consecutive days or longer.

  • Measure Type
    Process
    Electronic Clinical Quality Measure (eCQM)
    No
    Level Of Analysis
    Health Plan
    Care Setting
    Other Care Setting (Please specify)
    MAT output not attached
    Attached
    Data dictionary not attached
    No
    Numerator

    Any member in the denominator with opioid prescription claims where the MED is greater than 120mg for 90 consecutive days or longer*

    *MED calculation is included in S.6 Numerator Details

    Denominator

    Any member with two or more prescription claims for opioids filled on at least two separate days, for which the sum of the days supply is greater than or equal to 15.

    Exclusions

    Any member with a diagnosis for Cancer or a Prescription Drug Hierarchical Condition Category (RxHCC) 8, 9, 10, or 11 for Payment Year 2015; or RxHCC 15, 16, 17, 18, or 19 for Payment Year 2016 (see list in S.11 and S.2b); or a hospice indicator (Medicare Part D) from the enrollment database.

    All information required to stratify the measure results
    Off
    All information required to stratify the measure results
    Off
    Testing Data Sources
    Claims Data
  • Risk Adjustment
    No risk adjustment or risk stratification
    Risk adjustment approach
    Off
    Risk adjustment approach
    Off
    Conceptual model for risk adjustment
    Off
    Conceptual model for risk adjustment
    Off
  • Most Recent Endorsement Activity
    Endorsed Patient Safety Project 2015-2017, Phase 3
    Initial Endorsement
    Next Planned Maintenance Review
    Spring 2025
    Endorsement Status
    Endorsed
    Last Updated
  • Detailed Measure Specifications
    No
    Logic Model
    Off
    Impact and Gap
    No
    Feasibility assessment methodology and results
    No
    Address health equity
    No
    Measure’s use or intended use
    No
    508 Compliance
    Off
    If no, attest that all information will be provided in other fields in the submission.
    Off