Understanding your Department of Human Services (DHS) opioid prescribing report
Explore this page for information about elements found in the DHS Opioid Prescribing Reports.
Explore this page for information about elements found in the DHS Opioid Prescribing Reports.
The data in each report comes from Medicaid and MinnesotaCare pharmacy claims data (not the Minnesota Prescription Drug Monitoring Program). This means that only data on Medicaid and MinnesotaCare patients are included in the DHS prescribing reports. The following patients, settings or medications are excluded from the reports:
Enrollees excluded based on cancer or hospice have no data in the prescribing report. An enrollee who receives an excluded medication will just have that medication data excluded from the data. Any included opioid formulations prescribed to that enrollee in the measurement year are included.
The reports compare providers’ prescribing data to the average rate of their anonymized peers. Providers are included in one of 30 specialty groups based on their National Provider Identifier (NPI) primary taxonomy code, or based on direct confirmation with the provider about their practice type.
DHS uses the following specialty groups for the opioid prescribing reports:
Addiction Medicine; Allergy and Immunology; Anesthesiology; Dental—General; Dermatology; Emergency Medicine; Family Medicine; Hospice; Hospitalist; Internal Medicine; Obstetrics and Gynecology; Oncology; Ophthalmology; Optometry; Oral and Dental Surgery; Orthopedic Surgery; Otolaryngology; Pain Medicine; Pathology; Pediatrics; Physical Medicine and Rehabilitation; Physician Assistant and Advance Practice Nurse; Podiatry-General; Podiatry-Surgical; Preventive Medicine; Psychiatry and Neurology; Radiology; Rheumatology; Specialty; Surgery; Urology
Your specialty information comes from the Centers for Medicare & Medicaid Services (CMS) National Plan and Provider Enumeration System. Your specialty group is based on your National Provider Identifier (NPI) primary taxonomy code. The taxonomy code uses a unique alphanumeric code, 10 characters in length. The code set is structured into three distinct levels: provider grouping, classification and area of specialization. (American Medical Association. Health Care Provider Taxonomy. Version 19.0 January 2019).
Providers self-select their taxonomy codes. The taxonomy codes are organized based on education and training and are used to define specialty, not specific services that are rendered.
Your unique National Provider Identifier number.
The report also provides your name on file with DHS. The address included in the report is the public address on file with the prescribers’ respective licensing board, with one exception. Podiatrists’ reports are mailed to the address on file with DHS.
The legend explains how to read the graphs in the report:
Specialty comparison data for all seven measures is provided in the reports. If a provider’s specialty is not correctly designated on the report, the averages for each sentinel measure for all 30 specialties is available on the Sentinel Measures: averages by specialty webpage.
The quality improvement thresholds were set based on careful analysis of Medicaid and MinnesotaCare administrative prescribing data (claims data). In general, the thresholds were set at a rate that represented an inflection point between high volume and low volume prescribers in the data analysis. The threshold will remain at their current numbers, unless DHS is advised to change the thresholds by a clinical advisory body.
The quality improvement thresholds do not differ among specialties. The quality improvement threshold are listed below:
This measure shows the percent of enrollees prescribed one or more index opioid prescriptions between January and December of the measurement year:
The graph shows:
In the sample report: Dr. Fake Prescriber prescribed an index opioid prescription to 2.1 percent of the 281 Minnesota Medicaid and MinnesotaCare enrollees she saw in the measurement year (denominator = 281 enrollees). Her peers in her specialty group prescribed an index opioid prescription to 2.5 percent of the Minnesota Medicaid and MinnesotaCare enrollees they saw. Dr. Prescriber’s prescribing rate is under the quality improvement threshold of greater than 8 percent.
This measure shows the percent of index opioid prescriptions that exceeded the recommended dose in the measurement year. The recommended dose is less than 100 morphine milligram equivalence (MME) for medical specialties and less than 200 MME for surgical specialties.
The graph shows:
In the sample report: Of the six index opioid prescriptions Dr. Fake Prescriber prescribed in the measurement year, 16.7 percent exceeded 100 MME (denominator = 6 prescriptions). Her peers in family medicine prescribed index opioid prescriptions greater than 100 MME 28.5 percent of the time. Dr. Prescriber’s prescribing rate is under the quality improvement threshold of 50 percent.
This measure shows the percent of opioid prescriptions prescribed that met or exceeded 700 cumulative MME in the post-acute pain phase (up to 45 days following an acute event). This includes the index opioid prescription and any other opioids prescribed within a 45-day window of the date of the index opioid prescription.
The graph shows:
In the sample report: Dr. Fake Prescriber did not prescribe an opioid prescription that crossed the 700 cumulative MME threshold during the post-acute pain period (denominator = 9). The average her Family Practice specialty was 5.5 percent. Dr. Prescriber’s percentage is under the quality improvement threshold of 15 percent.
This measure shows the number of patients prescribed an opioid prescription during a period of chronic opioid analgesic therapy (COAT) in the measurement year:
The graph shows:
In the sample report: Dr. Fake Prescriber prescribed an opioid prescription to a patient with COAT 10 percent of the time. The average her Family Practice specialty was 23.6 percent. There is no quality improvement threshold for this measure.
This measure shows the percent of patients prescribed COAT with the daily dose exceeding 90 MME per day in the measurement year:
The graph shows:
In the sample report: Dr. Fake Prescriber did not prescribe opioids exceeding 90 MME per day to any patients receiving COAT in the measurement year. Her peers within her specialty group prescribed opioids exceeding 90 MME/day to patients receiving COAT 2.2 percent of the time.
This measure shows the percent of patients receiving elevated doses of COAT who received a concomitant benzodiazepine prescription:
The graph shows:
In the sample report: Dr. Fake Prescriber did not prescribe elevated dose COAT and concomitant benzodiazepines. Her peers prescribed elevated dose COAT and concomitant benzodiazepines 1.7 percent of the time they prescribed COAT.
This measure shows the percent of COAT patients receiving opioids from multiple prescribers:
The graph shows:
In the sample report: Dr. Fake Prescriber did not prescribe COAT to any patients who received opioids from more than two other providers during the COAT span in the measurement year. She prescribed COAT to one patient in the measurement year (denominator = 1).
Submit questions or feedback about your report to the Opioid Prescribing Improvement Program (OPIP) Inquiry.