While the problem has been increasing, multiple states are creating action plans and requiring or contemplating requiring clinicians in their Medicaid networks to dedicate some portion of their continuing education training to opioid education. This is a great first step but it should be a first step in a broader strategy to ensure that lives are saved, high costs are avoided, and clinicians can best allocate and delegate their limited resources.
Training and Educating your provider community
There is an increased level of education that could be useful to most clinicians. This is a logical first step that will likely help mitigate the growth of the epidemic; however, it is a first step. Providing education around cultural issues and the Social Determinants of Health will help providers better understand relevant information about their patient population that could be a root cause driver of opioid abuse.
Identify Problem Areas
While there has been an uptick in funding to address the opioid epidemic, resources are not unlimited and all providers do not need the same level of training. In fact, there is a potential risk to losing provider and stakeholder buy-in by not recognizing that there are unique needs for unique practices. Determining where in your coverage areas have the most ER visits, which providers are prescribing the most buprenorphine with another opioid, or which providers are prescribing high doses of opioids without a malignant cancer diagnoses are helpful starting points to determine where more training could be needed.
Assess, understand, and train to the performance gap
Analytics by themselves do not tell the full picture of why providers are performing in certain ways. Using analytics to then target and provide assessments to clinicians to understand gaps in training or better understand their unique practice needs is the key step to better addressing the opioid epidemic because you are focusing on fixing a specific issue that is relevant to that practice. Based on data analytics and assessments provides targeted training that is designed to improve the metrics and assessment areas where clinicians need help.
Reporting and Tracking
The opioid epidemic will not be solved in one year, it will take continuing education, targeted training that leads to improvement in clinical and financial outcomes, and then retooling the training to continue to address the opioid epidemic as it evolves.
Key Questions to Consider
• How will I track which providers have completed their continuing education training? Did training alone improve performance? How will I hold providers accountable?
• What is your strategy to identify and provide additional resources to hot spots?
o How are you going to help these people improve their performance?
o What are the metrics that matter most?
o What metrics are indicative of short-term and long-term improvement? How are you specifically targeting these metrics?
• What does success look like in your community, on a claims file, and to external stakeholders?
o How will you demonstrate results and show where continued work needs to be done?
Bringing it together
The goal of an effective opioid strategy should be to raise the floor on the levels of understanding on how to treat the epidemic and the social health factors that contributed to the epidemic. Once the floor has been raised then target those providers and areas that have additional needs and take the time to understand the gaps in training so that you are maximizing the effectiveness of your training efforts. This training should be explicitly tied to improving performance deficiencies. And finally, remember this isn’t a onetime process and have a clear plan to measure performance, share results that are understandable, and determine what needs to be changed in phase two.
Thomas Friedman is the senior product manager in payer and community health at Relias Learning. Tom brings executive experience working in healthcare payer strategic planning, finance, government affairs, and analytics having most recently served as the Director of Policy, Planning, and Analysis for the State Health Plan of North Carolina. He has worked in multiple states (such as North Carolina, New Hampshire, and Massachusetts) and in multiple payer settings including commercial, Medicaid, Medicare, as well as dual eligibles. Tom received his Bachelor’s degree from the University of Arizona and a Master’s of Public Administration from the University of Delaware.
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker’s Hospital Review/Becker’s Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.
