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Understanding your Department of Human Services (DHS) opioid prescribing report

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

Your specialty

DHS uses the following specialty groups for the opioid prescribing reports: 

Addiction Medicine; Allergy and Immunology; Anesthesiology; Dental—General; Dermatology; Emergency Medicine; Family Medicine; Hospice; Hospitalist; Internal Medicine; Obstetrics and Gynecology; Oncology; Ophthalmology; Optometry; Oral and Dental Surgery; Orthopedic Surgery; Otolaryngology; Pain Medicine; Pathology; Pediatrics; Physical Medicine and Rehabilitation; Physician Assistant and Advance Practice Nurse; Podiatry-General; Podiatry-Surgical; Preventive Medicine; Psychiatry and Neurology; Radiology; Rheumatology; Specialty; Surgery; Urology

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, 10 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).

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 a provider’s area of specialization to assign a provider to a specialty group, unless the data was unavailable. In those instances, DHS relied on the provider’s classification and internal DHS provider enrollment data. 

NPI

Your unique National Provider Identifier number.

Name and address

The report also provides your name on file with DHS. DHS mailed individual reports to the public address on file with the respective medical, nursing and dental licensing boards. Information in the reports is confidential and is not shared with health systems, employers or licensing boards. DHS mailed podiatrists’ reports to the 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

Measure 1: Percent of enrollees prescribed an index opioid prescription

This measure shows the percent of enrollees prescribed one or more index opioid prescriptions between October 2018 and September 2019:

  • The numerator: the number of opioid naïve enrollees prescribed a new opioid prescriptions in the measurement year.
  • The denominator: the number of enrollees seen in the measurement year.

The graph shows:

  • Blue bar: the number of enrollees you prescribed one or more index opioid prescriptions to in the measurement year divided by the number of enrollees you saw in the measurement year.
  • Orange bar: the number of enrollees your peers prescribed one or more index opioid prescriptions to in the measurement year divided by the number of enrollees they saw in the measurement year.
  • 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 for the 2019 reports.

In the sample report: Dr. Fake Prescriber prescribed an index opioid prescription to 2.1% of the 281 Minnesota Medicaid and MinnesotaCare enrollees she saw in the measurement year (denominator = 281 enrollees). Her peers in her specialty group prescribed an index opioid prescription to 2.5% of the Minnesota Medicaid and MinnesotaCare enrollees they saw. Dr. Prescriber’s prescribing rate is under the quality improvement threshold of greater than 8%. 

Measure 2: Percent of index opioid prescriptions exceeding the recommended dose

This measure shows the percent of index opioid prescriptions that exceeded the recommended dose in the measurement year. 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 the measurement year.
  • The denominator: the number of index opioid prescriptions prescribed in the measurement year.

The graph shows:

  • Blue bar: the number of index opioid prescriptions you prescribed that exceeded the recommended dose in the measurement year divided by the number of index opioid prescriptions you prescribed in the measurement year.
  • Orange bar: the number of index opioid prescriptions your peers prescribed that exceeded the recommended dose in the measurement year divided by the number of index opioid prescriptions they prescribed in the measurement year.
  • 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 the measurement year, 33.3% exceeded 100 MME (denominator = 6 prescriptions). Her peers in family medicine prescribed index opioid prescriptions greater than 100 MME 39.6% of the time. Dr. Prescriber’s prescribing rate is under the quality improvement threshold of 50%. 

Measure 3: Percent of prescriptions exceeding 700 cumulative MME 

This measure shows the percent of opioid prescriptions prescribed that met or exceeded 700 cumulative MME in the post-acute pain phase (up to 45 days following an acute event). 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 met or exceeded the 700 cumulative MME threshold in the measurement year.
  • The denominator: the number of opioid prescriptions prescribed during the post-acute pain period in the measurement year.

The graph shows:

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

In the sample report: Dr. Fake Prescriber did not prescribe an opioid prescription that crossed the 700 cumulative MME threshold during the post-acute pain period (denominator = 9). The average her Family Practice specialty was 8.9%. Dr. Prescriber’s percentage is under the quality improvement threshold of 15%.

Measure 4: Percent of patients with chronic opioid analgesic therapy (COAT)

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

  • The numerator: the number of patients prescribed an opioid in the measurement year 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 the measurement year.

The graph shows:

  • Blue bar: the number of patients you prescribed at least one opioid prescription to during a period of 60 consecutive days’ supply of opioids divided by the number of patients you prescribed at least one opioid prescription to in the measurement year 
  • Orange bar: the number of patients your peers prescribed at least one opioid prescription to during a period of 60 consecutive days’ supply of opioids divided by the number of patients your peers prescribed at least one opioid prescription to in the measurement year 
  • The quality improvement threshold: none.

In the sample report: Dr. Fake Prescriber prescribed an opioid prescription to a patient with COAT 9.1% of the time. The average her Family Practice specialty was 23.8%. There is no quality improvement threshold for this measure.

Measure 5: Percent COAT enrollees exceeding 90 MME/day

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

  • The numerator: the number of patients prescribed at least a 28 days’ supply of opioids to an enrollees within a COAT span in the measurement year with the daily dose exceeding 90 MME/day.
  • The denominator: the number of patients with an opioid prescription during a COAT period in the measurement year.  

The graph shows:

  • Blue bar: the number of patients you prescribed at least a 28 days’ supply of opioids within a COAT span in the measurement year with the daily dose exceeding 90 MME/day divided by the number of patients you saw on COAT in the measurement year. 
  • Orange bar: the number of patients your peers prescribed at least a 28 days’ supply of opioids within a COAT span in the measurement year with the daily dose exceeding 90 MME/day divided by the number of patients they saw on COAT in the measurement year. 
  • 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 the measurement year. Her peers within her specialty group prescribed opioids exceeding 90 MME/day to patients receiving COAT 3.1% of the time.

Measure 6: Percent COAT enrollees receiving concomitant benzodiazepines

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 at least a 28 days’ supply of opioids within a COAT span greater than 50 MME/day and an overlapping benzodiazepine prescription greater than 7 days in the measurement year.
  • The denominator: the number of patients prescribed an opioid prescription during a COAT period in the measurement year.

The graph shows:

  • Blue bar: the number of patients you prescribed at least a 28 days’ supply of opioids within a COAT span greater than 50 MME/day and an overlapping benzodiazepine prescription greater than 7 days to in the measurement year divided by the number of patients you prescribed COAT in the measurement year.
  • Orange bar: the number of patients your peers prescribed at least a 28 days’ supply of opioids within a COAT span greater than 50 MME/day and an overlapping benzodiazepine prescription greater than 7 days to in the measurement year divided by the number of patients they prescribed COAT in the measurement year.
  • 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 2.5% of the time they prescribed COAT. 

Measure 7: Percent of COAT patients receiving opioids from multiple providers 

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 the measurement year.
  • The denominator: the number of patients prescribed COAT in the measurement year.

The graph shows:

  • Blue bar: the number of patients you prescribed COAT to who received opioids from two or more additional providers divided by the number of patients you prescribed COAT in the measurement year.
  • Orange bar: the number of patients your peers prescribed COAT to who received opioids from two or more additional providers divided by the number of patients your peers prescribed COAT to in the measurement year
  • 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 the measurement year. She prescribed COAT to one patients in the measurement year (denominator = 1). 

Questions or feedback?

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

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