Friday, May 8, 2015

Opioid Scripts Are Up Partly Due to an Obamacare Incentive Program That Even Sen. Feinstein Warned About

This is a classic example of how bureaucrats and legislators fail to appreciate the unintended consequences of interventionist actions that appear wonderful upon first glance. 

This is from Robert King writing at the Washington Examiner:
Experts say too many patients are being prescribed opioid painkillers by emergency room doctors, and a program created by Obamacare could be enabling the problem. 
A new study released this week found 17 percent of nearly 20,000 patients were discharged from emergency rooms with an opioid prescription. Experts and lawmakers say a push under Obamacare for hospitals to get good patient satisfaction scores is one cause of the problem. 
America is in the midst of an opioid "epidemic," according to the Centers for Disease Control and Prevention. Painkillers killed more than 16,000 people in 2013. A huge part of the problem is the prescribing of painkillers, which quadrupled from 1999 to 2013. ...
Patients with back pain got the most opioids, followed by those with abdominal pain. "The majority of prescriptions had small pill counts and almost exclusively immediate-release formulations," according to the study. 
Oxycodone, the active ingredient in Oxycontin, was the most prescribed, with 52 percent. 
Doctors may feel pressured by hospital administrators to prescribe opioids because it may lead to a better score on a patient satisfaction survey, experts said. 
A program created by Obamacare tied extra funding to high scores on the survey. 
"Their reimbursement and quality ratings are linked to ways patients rate them on categories," said Dr. Andrew Kolodny, president of the doctor advocacy group Physicians for Responsible Opioid Prescribing. 
The survey has three questions about pain, including whether the physician adequately treated pain. 
While it sounds like a benign question, "it forces physicians and surgeons to not only ask about pain but be sure they are prescribing appropriate medication," said Dr. David St. Peter, a hospitalist with Saratoga Hospital in New York. St. ... 
This practice hasn't gone unnoticed by Congress. 
Sens. Chuck Grassley, R-Iowa, and Dianne Feinstein, D-Calif., wrote to CMS last year that the surveys could impact opioid prescribing. The senators cited news reports of doctors in South Carolina admitting to prescribing more opioids in response to patient survey scores. 
"One hospital with low satisfaction scores even went so far as to offer Vicodin 'goody bags' to patients discharged from its emergency room in an effort to improve its scores," the letter from the senators reads. ...