Required activities

Providers who are required to participate in the quality improvement (QI) program are notified of their QI status when they receive their annual opioid prescribing report in the spring of each year.

Minnesota Department of Human Services (DHS) QI framework follows a simplified version of the improvement model found in the ICSI Opioid Prescribing Quality Improvement Guide.

QI participants are encouraged to contact DHS at any time with questions about their data or the project. Consultations with DHS program staff and contracted medical experts are available by sending an email to dhs.opioid@state.mn.us.

Quality improvement program requirements

Step 1: Understand the improvement opportunity

Review your 2023 DHS Opioid Prescribing Report provided by DHS or your workplace
Review the Sentinel opioid prescribing measures webpage for each measure where quality improvement participation is required.

Step 2: Review standards of practice; identify challenges, barriers, stressors; choose a change

Review the Community Standards of Practice (PDF) and additional guidelines, as needed
Review and complete the self-assessment form found on the Project forms and QI resources webpage for each measure where quality improvement is indicated and email forms to DHS at dhs.opioid@state.mn.us.

Step 3: Plan the change

Complete a QI Plan Form which addresses at least one of the measures where QI is indicated and submit to DHS. Participants must submit a self-assessment form for each measure where QI participation is required, but only one QI plan form is required. The QI plan must address at least one of the measures or pain phases where quality improvement is required.
DHS will review the self-assessments and the QI Plan to confirm that the QI project is associated with the measure or phase indicated. DHS will provide prompt feedback on the plan.

Step 4: Do the change; study the outcomes; sustain the improvements

Test your change, evaluate the outcomes and sustainability
Submit a QI Evaluation Form to DHS by Dec. 31, 2024. DHS will provide feedback in early 2025.

Chronic Pain Waiver

Chronic pain is a clinically complex phenomenon and individualized, patient-centered care is imperative, whether opioids are part of the treatment plan or not. DHS partnered with a panel of pain management experts to develop a tenable alternative to quality improvement requirements for those who treat chronic pain. The alternative, referred to as a waiver, emphasizes processes that uphold patient safety and clinical practice guidelines.

The waiver is available to clinics specializing in pain management and includes all licensed prescribers on staff, regardless of their engagement in OPIP. Any clinic that meets all the following criteria can apply for a waiver:

Clinic or group must specialize in the treatment of chronic pain, and
Clinic or group must have at least one board-certified pain specialist on staff, and
Clinic or group must not have any open or pending investigations with DHS’ Office of the Inspector General, and
Individual clinicians must not have any disciplinary actions related to opioids with the Board of Medical Practice or Board of Nursing within the previous two years (24 months).

Email dhs.opioid@state.mn.us to request an application to apply for a waiver. DHS clinical contractors will review the materials after receiving the waiver application and then make a recommendation for approval or denial to the Assistance Commissioner of the Health Care Administration.

The 2024 QI program focuses on four of the seven OPIP sentinel measures:

Measure 2: Percent of index opioid prescriptions over the recommended dose (greater than 100 total MME for nonsurgical specialists; greater than 200 MME for surgical specialists).
Measure 3: Percent of prescriptions in the post-acute pain period that meet or exceed 700 cumulative MME.
Measure 5: Percent of patients receiving chronic opioid analgesic therapy (COAT) greater than 90 MME per day.
Measure 6: Percent of COAT patients receiving concomitant benzodiazepines.