Claims data analysis of provider-to-provider tele-mentoring program impact on opioid prescribing in Missouri

Olabode B. Ogundele; Xing Song; Praveen Rao; Tracy Greever-Rice; Suzanne A. Boren; Karen Edison; Douglas Burgess; Mirna Becevic

doi:10.5055/jom.0825

Authors

Olabode B. Ogundele, MS
Xing Song, PhD
Praveen Rao, PhD
Tracy Greever-Rice, PhD
Suzanne A. Boren, PhD
Karen Edison, MD
Douglas Burgess, MD
Mirna Becevic, PhD https://orcid.org/0000-0001-6520-1581

DOI:

https://doi.org/10.5055/jom.0825

Keywords:

telehealth, claims analyses, Extension for Community Healthcare Outcomes, continuing medical education, pain management, opioid analgesics

Abstract

Objective: The objective of this study was to assess opioid prescribing patterns of primary care providers (PCPs) participating in a virtual tele-mentoring program for patients with chronic pain as compared to nonparticipants.

Design: We utilized Missouri Medicaid claims from 2013 to 2021 to compare opioid prescription dosages and daily supply of opioids prescribed by PCPs. Participants and nonparticipants were matched using propensity score matching.

Setting: Missouri Medicaid data were received through partnership with the Center for Health Policy's MO HealthNet Data Project, the state's leading provider of Medicaid data.

Participants: Missouri-based prescribers.

Intervention: Show-Me Project Extension for Community Healthcare Outcomes (ECHO), an evidence-based provider-to-provider telehealth intervention that connects PCPs with a team of specialists.

Main outcome measures: We compared the rate of prescription opioid >50 morphine milligram equivalents (MMEs), mean MMEs/day, and mean number of daily supply to understand the impact of the ECHO model on providers' opioid prescribing.

Results: Patients treated by ECHO providers have 33 percent lower odds of being prescribed opioid dose >50 MME/day (p < 0.001) compared to non-ECHO providers. There is also a 14 percent reduction in the average opioid dose prescribed to patients of ECHO providers (p < 0.001). We observed a 3 percent (p < 0.001) reduction in average daily supply of opioids among patients of ECHO providers compared to the comparison group.

Conclusions: Pain Management ECHO supports PCPs with needed education and skills to provide specialty care in the management of pain conditions and safe prescribing of opioid medications.

Author Biographies

Olabode B. Ogundele, MS

Institute for Data Science and Informatics; Missouri Telehealth Network, University of Missouri, Columbia, Missouri

Xing Song, PhD

Institute for Data Science and Informatics; Biomedical Informatics, Biostatistics and Medical Epidemiology (BBME), Columbia, Missouri

Praveen Rao, PhD

Institute for Data Science and Informatics; Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, Missouri

Tracy Greever-Rice, PhD

Center for Health Policy, University of Missouri, Columbia, Missouri

Suzanne A. Boren, PhD

Institute for Data Science and Informatics; College of Health Sciences, University of Missouri, Columbia, Missouri

Karen Edison, MD

Missouri Telehealth Network; Center for Health Policy, Department of Dermatology, University of Missouri, Columbia, Missouri

Douglas Burgess, MD

Department of Psychiatry, University of Missouri-Kansas City (UMKC), Kansas City, Missouri

Mirna Becevic, PhD

Institute for Data Science and Informatics; Missouri Telehealth Network; Department of Dermatology, University of Missouri, Columbia, Missouri

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