MP72-16 LOW OPIOID FILL RATES CONTINUE DESPITE TERMINATION OF A FINANCIAL INCENTIVE FOR OPIOID-FREE VASECTOMIES

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You have accessJournal of UrologyCME1 Apr 2023MP72-16 LOW OPIOID FILL RATES CONTINUE DESPITE TERMINATION OF A FINANCIAL INCENTIVE FOR OPIOID-FREE VASECTOMIES Catherine S. Nam, Yen-Ling Lai, Hsou Mei Hu, Arvin K. George, Susan Linsell, Stephanie Ferrante, Mike Thompson, Chad Brummett, Jennifer F. Waljee, and James M. Dupree Catherine S. NamCatherine S. Nam More articles by this author , Yen-Ling LaiYen-Ling Lai More articles by this author , Hsou Mei HuHsou Mei Hu More articles by this author , Arvin K. GeorgeArvin K. George More articles by this author , Susan LinsellSusan Linsell More articles by this author , Stephanie FerranteStephanie Ferrante More articles by this author , Mike ThompsonMike Thompson More articles by this author , Chad BrummettChad Brummett More articles by this author , Jennifer F. WaljeeJennifer F. Waljee More articles by this author , and James M. DupreeJames M. Dupree More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003340.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Our prior work showed that financial incentive using modifier 22 by Blue Cross Blue Shield of Michigan (BCBSM) to encourage opioid-free vasectomy was associated with a significant decrease in initial opioid fills. However, this incentive was terminated on 12/31/21. We examined the change in initial opioid fill rate before and after termination of a quality incentive for opioid-free vasectomy. METHODS: We analyzed BCBSM administrative claims from 5/1/2021 to 8/31/2022. We included men 20 to 64 years old undergoing an office-based vasectomy or a control procedure with continuous enrollment. Our control group included patients undergoing office circumcision, cystoscopy, prostate biopsy, and transurethral destruction of prostate tissue. We excluded cases 2 months before and after the policy termination date of 12/31/21 to account for variation in uptake. Our primary outcome was the proportion of patients, both opioid naïve and not, who filled an opioid prescription within 3 days of their procedure (aka, “opioid fill rate”). We performed an interrupted time series analysis to estimate changes in opioid fill rates before and after 12/31/21 in the vasectomy and control groups. RESULTS: Our cohort included 2,209 who underwent vasectomy and 2,157 in the control group. Both groups had similar demographic and clinical attributes before and after 12/31/21, except the control group had statistically significant difference of smoking status and Charlson comorbidity score (p>0.01) Termination of the modifier 22 policy was not associated with a change in the opioid fill rate in the vasectomy group (-0.6% change [95% CI: -6.5% to 5.3%]). (Figure 1) Pre-termination, 9.1% of men filled an opioid prescription; post-termination, 6.9% of men filled an opioid prescription. In the control group, the termination of the modifier 22 policy was not associated with a change in the opioid fill rate (-0.6% change [95% CI: -6.6% to 5.5%]). CONCLUSIONS: Financial incentives that support opioid-free pathways have led to a rapid decrease in the rate of opioid fills after vasectomy. Even following termination of this incentive, the low opioid fill rate was sustained. These findings highlight the opportunity for a modifier 22 quality incentive to be applied for a limited period to have sustainable impact in lowering opioid fill rate. Source of Funding: n/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1030 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Catherine S. Nam More articles by this author Yen-Ling Lai More articles by this author Hsou Mei Hu More articles by this author Arvin K. George More articles by this author Susan Linsell More articles by this author Stephanie Ferrante More articles by this author Mike Thompson More articles by this author Chad Brummett More articles by this author Jennifer F. Waljee More articles by this author James M. Dupree More articles by this author Expand All Advertisement PDF downloadLoading ...