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Understanding your DHS opioid prescribing report

Explore this page for additional detail about elements found in the DHS Opioid Prescribing Reports.

Your specialty

Your specialty information comes from the CMS National Plan and Provider Enumeration System. Your specialty group is based on your National Provider Identifier (NPI) primary taxonomy code.
The taxonomy code uses a unique alphanumeric code, ten characters in length. The code set is structured into three distinct levels: provider grouping, classification and area of specialization. (American Medical Association. Health Care Provider Taxonomy. Version 19.0 January 2019).

  • Level I – provider grouping: A major grouping of services or occupations of health care providers, e.g., allopathic and osteopathic physicians, dental providers, hospitals.
  • Level II – classification: A more specific service or occupation to the provider grouping, e.g., the classification for allopathic and osteopathic physicians is based on the General Specialty Certificates issued by the appropriate national boards. The following boards will, however, have their general certificates appear as Level III areas of specialization due to display limitations of the code set for boards that have multiple general certifications: medical genetics, preventive medicine, psychiatry and neurology, radiology, surgery, otolaryngology, pathology.
  • Level III – area of specialization: A more specialized area of the classification in which a provider chooses to practice or make services available, e.g., the area of specialization for provider grouping allopathic and osteopathic physicians is based upon the Subspecialty Certificates as issued by the appropriate national boards.

Providers self-select their taxonomy codes. The taxonomy codes are organized based on education and training and are used to define specialty, not specific services that are rendered.

DHS used the Level III information to assign a provider to a specialty, unless that level of data was unavailable. In those instances, DHS relied on Level II information and internal DHS provider enrollment data.

NPI

Your unique National Provider Identifier number.

Name and address

The report also provides your name and address on file with DHS.

Legend

The legend explains how to read the graphs in the report:

  • The blue horizontal bar displays your specific data
  • The orange horizontal bar displays the average data within your specialty
  • The vertical red line indicates the quality improvement threshold for each given measure
  • The denominator shows your individual denominator for each measure.

Measure 1 (Acute)

This measure shows the percent of enrollees prescribed one or more index opioid prescriptions in 2018:

  • The numerator: the number of enrollees prescribed one or more index opioid prescriptions in 2018.
  • The denominator: the number of enrollees seen in 2018.

The graph shows:

  • Blue bar: the number of enrollees you prescribed one or more index opioid prescriptions to in 2018 divided by the number of enrollees you saw in 2018.
  • Orange bar: the number of enrollees your peers prescribed one or more index opioid prescriptions to in 2018 divided by the number of enrollees they saw in 2018.
  • The quality improvement threshold: greater than 8%. Note: the quality improvement threshold only applies to providers in nonsurgical specialties. There is no threshold for surgical specialties, including Obstetricians & Gynecologists.

Quality improvement for this measure will not be required in 2019.

In the sample report: Dr. Fake Prescriber prescribed an index opioid prescription to 2.1% of the 285 Minnesota Medicaid and MinnesotaCare members she saw in 2018 (denominator = 285 members). Her peers in her specialty group prescribed an index opioid prescription to 2.6% of the Minnesota Medicaid and MinnesotaCare members they saw. Dr. Prescriber’s prescribing rate is under the quality improvement threshold of greater than 8%. 

Measure 2 (Acute)

This measure shows the percent of index opioid prescriptions that exceeded the recommended dose in 2018. The recommended dose is less than 100 morphine milligram equivalence (MME) for medical specialties and less than 200 MME for surgical specialties.

  • The numerator: the number of index opioid prescriptions prescribed that exceeded the recommended dose in 2018.
  • The denominator: the number of index opioid prescriptions prescribed in 2018.

The graph shows:

  • Blue bar: the number of index opioid prescriptions you prescribed that exceeded the recommended dose in 2018 divided by the number of index opioid prescriptions you prescribed in 2018.
  • Orange bar: the number of index opioid prescriptions your peers prescribed that exceeded the recommended dose in 2018 divided by the number of index opioid prescriptions they prescribed in 2018.
  • The quality improvement threshold: greater than 50% for both medical and surgical specialties.

In the sample report: Of the six index opioid prescriptions Dr. Fake Prescriber prescribed in 2018, 33.3% exceeded 100 MME (denominator = 6 prescriptions). Her peers in family medicine prescribed index opioid prescriptions greater than 100 MME 43.9% of the time. Dr. Prescriber’s prescribing rate is under the quality improvement threshold of 50%.  

Measure 3 (Post-acute)

This measure shows the percent of opioid prescriptions prescribed that exceeded 700 cumulative MME in the post-acute pain phase. This includes the index opioid prescription and any other opioids prescribed within a 45-day window of the date of the index opioid prescription.

  • The numerator: the number of prescriptions prescribed during the post-acute pain period that exceeded the 700 cumulative MME threshold in 2018.
  • The denominator: the number of opioid prescriptions prescribed during the post-acute pain period in 2018.

The graph shows:

  • Blue bar: the number of prescriptions you prescribed during the post-acute pain period that exceeded the 700 cumulative MME threshold in 2018 divided by the number of opioid prescriptions you prescribed during the post-acute pain period in 2018.
  • Orange bar: the number of prescriptions your peers prescribed during the post-acute pain period that exceeded the 700 cumulative MME threshold in 2018 divided by the number of opioid prescriptions they prescribed during the post-acute pain period in 2018.
  • The quality improvement threshold: 15% for medical and surgical specialties.

In the sample report: Dr. Fake Prescriber prescribed opioid prescription that crossed the 700 cumulative MME threshold 10% of the time during the post-acute pain period (denominator = 10). The average her Family Practice specialty was 9.7%. Dr. Prescriber’s percentage is under the quality improvement threshold of 15%.

Measure 4 (Chronic)

This measure shows the number of patients prescribed an opioid prescription during a period of chronic opioid analgesic therapy (COAT) in 2018:

  • The numerator: the number of patients prescribed an opioid in 2018 during a span of COAT (greater than or equal to 60 consecutive days’ supply of opioids).
  • The denominator: the total number of patients with at least one opioid prescription prescribed in 2018.

The graph shows:

  • Your numerator and denominator as a fraction.
  • The quality improvement threshold: none.

In the sample report: Dr. Fake Prescriber prescribed opioid therapy to 12 patients during the measurement year. Two of the patients who received an opioid prescription from her received it during a span of chronic opioid analgesic therapy.  

Measure 5 (Chronic)

This measure shows the percent of patients prescribed COAT with the daily dose exceeding 90 MME/day in 2018:

  • The numerator: the number of patients prescribed COAT in 2018 with the daily dose exceeding 90 MME/day.
  • The denominator: the number of patients with an opioid prescription during a COAT period in 2018.  

The graph shows:

  • Blue bar: the number of patients you prescribed COAT to in 2018 with the daily dose exceeding 90 MME/day divided by the number of patients you saw on COAT in 2018. 
  • Orange bar: the number of patients your peers prescribed COAT to in 2018 with the daily dose exceeding 90 MME/day divided by the number of patients they saw on COAT in 2018. 
  • The quality improvement threshold: greater than 10%.

In the sample report: Dr. Fake Prescriber did not prescribe opioids exceeding 90 MME/day to any patients receiving COAT in 2018. Her peers within her specialty group prescribed opioids exceeding 90 MME/day to patients receiving COAT 3.4% of the time.

Measure 6 (Chronic)

This measure shows the percent of patients receiving elevated doses of COAT who received a concomitant benzodiazepine prescription:

  • The numerator: the number of patients prescribed COAT greater than 50 MME/day and an overlapping benzodiazepine prescription greater than 7 days in 2018.
  • The denominator: the number of patients prescribed an opioid prescription during a COAT period in 2018.

The graph shows:

  • Blue bar: the number of patients you prescribed COAT greater than 50 MME/day and an overlapping benzodiazepine prescription greater than 7 days to in 2018 divided by the number of patients you prescribed COAT in 2018.
  • Orange bar: the number of patients your peers prescribed COAT greater than 50 MME/day and an overlapping benzodiazepine prescription greater than 7 days to in 2018 divided by the number of patients they prescribed COAT in 2018.
  • The quality improvement threshold: greater than 10%.

In the sample report: Dr. Fake Prescriber did not prescribe elevated dose COAT and concomitant benzodiazepines. Her peers prescribed elevated dose COAT and concomitant benzodiazepines 2.7% of the time they prescribed COAT. 

Measure 7 (Chronic)

This measure shows the percent of COAT patients receiving opioids from multiple prescribers:

  • The numerator: the number of patients prescribed COAT who received opioids from more than two other providers while on COAT in 2018.
  • The denominator: the number of patients prescribed COAT in 2018.

The graph shows:

  • Your numerator and denominator as a fraction.
  • The quality improvement threshold: none.

In the sample report: Dr. Fake Prescriber did not prescribe COAT to any patients who received opioids from more than two other providers during the COAT span in 2018. She prescribed COAT to two patients in 2018 (denominator = 2). 

Questions or feedback?

Submit questions or feedback about your reports on the Opioid Prescribing Improvement Program website.

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