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Use of Opioids from Multiple Providers in Persons Without Cancer

CBE ID
2950
Endorsement Status
Endorsement Removed
E&M Committee Rationale/Justification

Steward no longer seeking to maintain endorsement

1.1 New or Maintenance
Maintenance
Previous Endorsement Cycle
Full Year 2015
Is Under Review
No
1.3 Measure Description

The proportion (XX out of 1,000) of individuals without cancer receiving prescriptions for opioids from four (4) or more prescribers AND four (4) or more pharmacies.

    • 1.14 Numerator

      Any member in the denominator who received opioid prescription claims from 4 or more prescribers AND 4 or more pharmacies.

    • 1.15 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 from the enrollment database.

    • 1.13a Data dictionary not attached
      No
    • Most Recent Endorsement Activity
      Endorsed Patient Safety Project 2015-2017, Phase 3
      Initial Endorsement
      Last Updated
      Removal Date
    • 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