More money for surgeons, less opioid-prescribing after procedures, study finds

Financial reimbursement incentives helped curb excessive opioid prescribing after surgical procedures, according a study published in JAMA Network Open.

In August 2018, the Michigan Opioid Prescribing and Engagement Network developed a pathway for managing pain that included counseling about pain management without opioids before surgery and prescriptions for nonopioid drugs for the week after surgery along with a predetermined prescription for oxycodone tablets, an opioid, for the first two days after surgery.

Simultaneously, Blue Cross Blue Shield of Michigan offered a financial incentive for using this pathway, a 35 percent reimbursement added to surgeons' professional fees.

For the study, researchers examined 1,459 operations performed at Ann Arbor-based University of Michigan Health System from Aug. 1, 2018, to March 31.

Of the 1,459 operations, 70.4 percent included use of the opioid-sparing pathway. The median utilization rate of this pathway was 91.7 percent. Surgeons attested to using the pathway in 50 percent of the cases, and they received reimbursement ranging from $389 to $753 per operation.

The rate of surgeons providing evidence that they used the pathway increased from 38.1 percent to 60.7 percent during the study period.

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