Sentinel opioid prescribing measures

Overview

The Opioid Prescribing Improvement Program's sentinel measures support the quality improvement arm of the program. These seven measures assess individual provider’s opioid prescribing behavior in the acute, post-acute and chronic pain phases and compare them to the prescribing rates of peers in the same specialty. Minnesota Department of Human Services (DHS) and the Opioid Prescribing Work Group developed the measures by analyzing Minnesota Medicaid and MinnesotaCare prescription data and considering national measures. 

DHS excludes the following patients or prescriptions from the data:

• Patients with a cancer diagnosis or treatment in the measurement year;
• Patients who received hospice services (from a Medicare or Medicaid-enrolled hospice provider);
• Medications used to treat Opioid Use Disorder;
• All buprenorphine products; and
• Procedural sedation or anesthesia and medications administered in an emergency department or from an inpatient pharmacy

Additional, comprehensive information include the following: 

• Review the averages of each sentinel measure by clinical specialty
• Learn how to interpret the Opioid Prescribing Improvement Program in the Opioid Prescribing Improvement Program Sentinel Measures (PDF).
• Review the complete technical specifications for each of the Opioid Prescribing Improvement Program sentinel measures in the Opioid Prescribing Improvement Program Sentinel Measures (PDF).

Measure definitions

A brief description of each measure is provided below, and you can view one-page measure overviews for the four measures that have quality improvement requirements in 2022. 

Measure 1: Percent of patients prescribed an index opioid prescription.

Measure 2: Percent of index opioid prescriptions exceeding the recommended dose (greater than 100 morphine milligram equivalence for medical specialties; greater than 200 morphine milligram equivalence for surgical specialties). Review the Measure 2 Overview (nonsurgical specialties) (PDF) for medical specialties or the Measure 2 Overview (surgical specialties) (PDF). 

Measure 3: Percent of prescriptions exceeding 700 cumulative morphine milligram equivalence during the acute and post-acute pain period (date of index opioid prescription plus 45 days). Review the Measure 3 Overview (PDF).

Measure 4: Percent of patients with chronic opioid analgesic therapy.

Measure 5: Percent of patients on chronic opioid analgesic therapy exceeding 90 morphine milligram equivalence per day (high-dose chronic opioid analgesic therapy). Review the Measure 5 Overview (PDF).

Measure 6: Percent of patients receiving elevated-dose chronic opioid analgesic therapy (greater than 50 morphine milligram equivalence per day) who received concomitant benzodiazepine prescriptions. Review the Measure 6 Overview (PDF). 

Measure 7: Percent of patients on chronic opioid analgesic therapy who receive opioids from multiple providers.