Announcing New Board Opioid Initiative
I am delighted to share some exciting Alliance news. As a way to support not just reporting on the health care system, but propelling action to improve it, the Alliance’s Board of Directors has committed to an initiative to reduce opioid prescribing in our state, focusing on appropriate use of opioid prescriptions for low back pain and dental care. We are calling this initiative the Washington Health Alliance Board Opioid Impact Project. This is the first time we are undertaking an initiative of this type and we believe it is unique in the nation.
We are fortunate to have a talented and committed Board, comprised of twenty-four senior business and healthcare leaders from across the state. Together, they represent more than 133,000 employees, 3,800 providers and more than 4 million insured lives. Each Board member has been asked to commit their time and talent, and that of their organizations, to this effort. We are very happy to be working in close partnership with another Alliance member, Delta Dental of Washington, on this effort.
The overuse of opioids and potential is well-known. The Alliance reported on Opioids in Washington State by cities and regions, insurance type, and age. Our most recent First, Do No Harm report showed that opiates prescribed for acute low back pain in the first four weeks impacted more than 600,000 people at a cost of more than $88 million in Washington state from 2014 to 2017. In a CDC report on opioid prescribing rates across the county, the 2017 rate of prescribing for opioids was 57.2 for every 100 Washington residents. That’s certainly lower than Alabama, with the highest ratio of 107.2 per 100 people, but a far cry from Hawaii with 37, New York with 37.8, and Minnesota with 41.
On the national front, recent research shows that the opioid crisis has cost our country more than $631 billion. More than two-thirds of the expense fell to individuals and the private sector and one-third fell on federal, state, and local governments. About 40% of the costs, $205 billion, related to the estimated losses due to lost lifetime earnings for people who died from overdoses. The CDC reports that more than 70,000 people died from drug overdoses in 2017 and that opioids were involved in 68% of them, a 10% increase from 2016. Another CDC study shows that even a one-day opioid prescription carries a 6% risk of usage one year later.
Over the next few months, the Alliance team will host several health plan, provider, and purchaser stakeholder meetings with representatives from Board member organizations. These groups individually, and then collectively, will make recommendations to the Board of Directors on the most important actions we can take as a community to accomplish two goals within 12 months of establishing a baseline performance:
- for opioids for acute low back pain, to reduce the Health Waste Index by 10%;
- for opioids prescribed for dental care, to reduce the rate of opioids prescribed by dental practitioners that are “against guidelines” (not in compliance with guidelines) by 7%. This will include reductions in two measures:
- the rate of opioids prescribed by dental practitioners that include more than a 3-day supply for dental patients age 24 and over; and
- the rate of opioids prescribed by dental practitioners that include more than a 7-day supply for dental patients age 25 and over.
I believe the Board Impact Initiative can help us make a tremendous impact, not only reducing low-value care, but helping people avoid the destruction of addiction.
I look forward to keeping you apprised of our progress on this new endeavor and, as always, I appreciate your support.
All the best,
Nancy A. Giunto