Entries in Reform & Regulatory (114)

Wednesday
May232018

Too Many Poor Excuses

Too Many Poor Excuses
 

By Kim Bellard, May 23, 2018

 

I am so tired of reading yet another story about how we — Americans — cannot afford things. Not luxury item. Increasingly, it seems like too many of us can’t afford what most people would consider basics — food, housing, child care, transportation.

 

And health care, of course.

 

new study by the United Way ALICE Project found that 51 million households can’t afford a basic monthly budget that includes food, housing, health care, child care, and a cell phone. That is 43% of all U.S. households.

 

ALICE stands for Assets Limited, Income Constrained, Employed. Of the 51 million households, two-thirds are ALICE ones. These are working households that, in a prior era, might have been thought of as middle class.

 

Now they are living paycheck to paycheck, and fearing sudden expenses — like an unexpected health care bills. Maybe they can’t afford their insulin, their inhalers, or their epipens anymore. And, of course, God forbid they end up in the emergency room or get out-of-network care.

 

Indeed, a hospital stay may result in a permanent reduction in income, even if you have insurance, according to a study released earlier this year. We shouldn’t be surprised that the Commonwealth Fund recently found that the percentage of Americans who feel confident they can afford the health care they need continues to fall. Only 62% re very or somewhat confident, down from 69% just three years ago. Twenty-four percent reported health care has become harder to afford over the last year.

 

Another new study found that 40% of us skipped a recommended test or treatment due to cost, and 44% skipped seeing a doctor when sick or injured due to concerns about costs. More feared the cost of a serious illness than they did the serious illness itself.

 

That is seriously wrong.

 

And there are no signs of anything improving. The number of uninsured is rising again. Actions by the Trump Administration to undermine the ACA exchange markets are estimated to have drastic increases on health insurance premiums — potentially jumping by 35% to 94% over the next three years. Plus, HHS has proposed rules for so-called short-term health insurance policies that the CMS

 

Actuary says will simply increase costs for everyone else, not to mention that those “covered” under those policies will find that coverage to be skimpy if/when they need it.

 

This all adds up. Kaiser Health News reports that, in addition to bankruptcies due to health care bills, nearly 40% of adults under 65 have had their credit scores lowered due to medical debts. A 2014 Consumer Financial Protection Bureau report found that almost 20% of credit reports had at least one medical collection account listed.

 

The sad truth is that only 39% of Americans say they could handle an unexpected expense of even $1,000 — and 34% had had a major unexpected expense over the past year. Not surprisingly, we are doing a terrible job saving for retirement. Increasingly, we’re both saying we’ll have to rely on Social Security for our retirement income, while lamenting that we’re not very confident it will be there when we need it.

 

These problems are not about our having enough money. We do. They are not just problems for “poor people.” They are problems for the majority of us. These are problems of priorities, and somewhere along the way our have gotten screwed up.

 

We’re making too many poor excuses for not doing more and for not doing better. It’s time to stop.
 
This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting

 
Friday
Jan192018

2018 CMS Medicare Shared Savings Program: 43 Previous ACOs out, 124 New ACOs In

By Clive Riddle, January 19, 2018

CMS recently published 2018 Medicare Shared Savings Program information.  After comparing the listing of 561 2018 MSSP participants to the 480 2017 participants, we found 43 2017 ACOs have exited the program for 2018, and there are 124 new ACOs for 2018.  Caravan Health has sponsored 15 new ACOs, and Community Health Systems is sponsoring 14 of the new ACOs.

Here’s the list for the 43 ACOs exiting the program:

  1. Accountable Care Coalition of Mount Kisco (CT, NY)
  2. Accountable Care Coalition of Western Georgia (AL, GA)
  3. ACO of East Hawaii (HI)
  4. Advanced Premier Physicians ACO (CA)
  5. APCN-ACO (CA)
  6. ApolloMed Accountable Care Organization (CA, FL, HI)
  7. Arkansas High Performance Network ACO of FQHC (AR, KY)
  8. Arkansas HIgh Performance Network ACO (AR)
  9. Bay Area Medical Associates ACO (CA)
  10. Bluegrass Clinical Partners (FL, KY, TN)
  11. Care Covenant (TX)
  12. Catholic Medical Partners-Accountable Care IPA (NY)
  13. CHRISTUS Louisiana ACO (LA)
  14. CHWN ACO (IL)
  15. Collaborative Health ACO (MA)
  16. Community Health Accountable Care (NH, NY, VT)
  17. Connected Care (MI)
  18. Cornerstone Health Enablement Strategic Solutions (NC)
  19. Health Leaders Medicare ACO Network (LA)
  20. Indiana Care Organization (IN)
  21. Kansas Primary Care Alliance (KS, MO)
  22. KCMPA-ACO (KS, MO)
  23. Mary Washington Health Alliance. (VA)
  24. Mercy ACO (AR, MO)
  25. MHT-ACO (GA, MI, OK, SC, TX)
  26. Midwest Quality Care Alliance (KS, MO)
  27. NEQCA Accountable Care, (MA)
  28. North Jersey ACO (NJ, NY)
  29. OneCare Vermont Accountable Care Organization (NH, VT)
  30. Oregon ACO (OR, WA)
  31. Palm Accountable Care Organization (FL)
  32. Physicians Accountable Care Solutions (CA, CO, CT, IL, NY, OH, PA, UT, WV)
  33. Physicians Collaborative Trust ACO (FL)
  34. Primaria ACO (IN)
  35. Primary Care Alliance (FL)
  36. Revere Health (AZ, UT)
  37. Shannon Clinic (TX)
  38. South Shore Physician-Hospital Organization (MA)
  39. SPACO (FL)
  40. Torrance Memorial Integrated Physicians (CA)
  41. UW Health ACO, (WI)
  42. VirtuaCare (NJ)
  43. Western Maryland Physician Network (MD, PA, VA, WV)

And here’s the list of the 124 new ACOs joining the program for 2018:

  1. Accountable Care Coalition of Alabama (AL)
  2. Account. Care Coal. of Community Health Centers (AR, DC, FL, IL, KY, MD, MI, RI)
  3. Accountable Care Coalition of New Jersey (NJ)
  4. Accountable Care of Nevada (NV)
  5. Accountable Care Organization of Aurora (IL, MI, WI)
  6. ACO West Virginia (PA, WV)
  7. Acorn Network (IL, IN, MI)
  8. Adventist Health Accountable Care (CA)
  9. Adventist Health System ACO (FL)
  10. Alabama Physician Network (AL)
  11. Aledade Accountable Care 22 (OH, PA)
  12. Aledade Accountable Care 25 (NJ)
  13. Aledade Accountable Care 35 (LA, MS, TN)
  14. Aledade Accountable Care 37 (MD, TN, VA, WV)
  15. Baptist Health/UAMS Accountable Care Alliance (AR, TX)
  16. Baptist Physician Partners ACO (FL, GA)
  17. Bethesda Health Quality Alliance (FL)
  18. Boulder Valley Care Network (CO)
  19. Bridges Health Partners ACO (PA)
  20. Caravan Health ACO 11 (AL, GA, IL, KY, NM, NV, TX)
  21. Caravan Health ACO 12 (MN, WI)
  22. Caravan Health ACO 13 (MA, NY, VT)
  23. Caravan Health ACO 14 (ID, MN)
  24. Caravan Health ACO 15 (IA, MN, NE, SD)
  25. Caravan Health ACO 16 (AL, TN)
  26. Caravan Health ACO 17 (OR)
  27. Caravan Health ACO 31 (OK)
  28. Caravan Health ACO 32 (OK)
  29. Caravan Health ACO 33 (OK)
  30. Caravan Health ACO 34 (OK)
  31. Carolinas HealthCare System ACO (NC, SC)
  32. Cascadia Care Network (WA)
  33. Centrus Health of Kansas City (KS, MO)
  34. CHSPSC ACO 1 (AL, FL, LA, MS)
  35. CHSPSC ACO 10 (FL)
  36. CHSPSC ACO 12 (GA, NC, SC, VA)
  37. CHSPSC ACO 13 (PA)
  38. CHSPSC ACO 14 (TN, WV)
  39. CHSPSC ACO 15 (KY, TN)
  40. CHSPSC ACO 16 (OK)
  41. CHSPSC ACO 17 (FL)
  42. CHSPSC ACO 2 (IN)
  43. CHSPSC ACO 21 (AL, FL)
  44. CHSPSC ACO 6 (TX)
  45. CHSPSC ACO 7 (AR, LA, MO, OK)
  46. CHSPSC ACO 8 (AK, AZ, NM, NV)
  47. CHSPSC ACO 9 (IN)
  48. Coastal One Health Partners (CA)
  49. ColigoCare (NJ, NY)
  50. Community Health Center Network Of Idaho (ID, OR, WA)
  51. Community Healthcare Partners ACO, (IL, IN)
  52. Connected Care of East Tennessee (AL, GA, TN)
  53. Connected Care of Middle Tennessee (TN)
  54. Connected Care of Mississippi (MS)
  55. Connected Care of West Tennessee (MS, TN)
  56. CPSI ACO 2 (CA, CO, GU, ID, ND, OR, SD, WA)
  57. CPSI ACO 3 (GA, MS, NC)
  58. CPSI ACO 7 (IA, IL, NE, WI, WV)
  59. CPSI ACO 8 (AR, LA, MO, TX)
  60. Crestwood Regional Healthcare Alliance (AL)
  61. CVACC (VA)
  62. DMH Health Network (IL)
  63. DOCACO GULF COAST (FL, SC)
  64. Einstein Care Partners (PA)
  65. Family Choice ACO (CA)
  66. Foothill Accountable Care Medical Group, (CA)
  67. Genesis Physicians Group (TX)
  68. Health Alliance ACO (DC, MD, VA)
  69. Healthcare Quality Partners (NJ, PA)
  70. HealthChoice (AR, MS, TN)
  71. Heritage Valley Healthcare Network ACO (OH, PA, WV)
  72. Holy Name Medical Center ACO (NJ)
  73. HP2 (GA)
  74. Independent Physicians Accountable Care (CA, CT, FL, SC, TX, VA)
  75. Inspire Health Partners (IN)
  76. Intermountain Accountable Care (NV, UT)
  77. Keep Well ACO (IL, KS, MO)
  78. KENNEDY HEALTH ALLIANCE (NJ)
  79. Kootenai Accountable Care (ID, WA)
  80. McFarland Clinic, PC (IA)
  81. McLeod Healthcare Network (NC, SC)
  82. MHC Accountable Care Organization (KY, OH, WV)
  83. MHN ACO (IA, IL, NE, SD)
  84. MSHP ACO (NY)
  85. MultiCare Connected Care (WA)
  86. NCH ACO (FL)
  87. NorthShore Physician Assoc. Value Based Care (IL)
  88. OhioHealth Venture (OH)
  89. Orange Accountable Care Organization (FL, MD, NJ, NM, PA, TX)
  90. Pacific Private Practice Network, Inc (CA, TX)
  91. PathfinderHealth (AZ)
  92. Physician Partners of Western PA (PA)
  93. Physician Performance Network of Arizona (AZ)
  94. Primary Comprehensive Care ACO (IL, NC)
  95. PRIMARY PARTNERS (FL)
  96. PRIME ACCOUNTABLE CARE WEST (AZ, CA, IL, NV)
  97. Privia Quality Network Gulf Coast II (TX)
  98. QHI ACO (CA, CT, IL)
  99. Renaissance Physicians Accountable Care (TX)
  100. Riverside Health Source (VA)
  101. Rush Health ACO (IL)
  102. Saint Francis Hospital Medicare ACO (AR, IL, MI, MS, TN)
  103. Select Physicians Associates (AL, FL)
  104. SIGNATURE NETWORK (VA)
  105. Space Coast Independent Practice Association (FL)
  106. St. Dominic Medical Associates (MS)
  107. St. Luke's ACO (IL, MO)
  108. St. Luke's Medicare ACO (NJ, PA)
  109. St. Tammany Hospital ACO (LA)
  110. Steward National Care Network, (FL, MA, NJ, OH, PA)
  111. The Iowa Clinic, P.C. (IA)
  112. The Ohio State Health ACO (OH)
  113. Treasure Coast Integrated Healthcare (FL)
  114. UC Davis Health ACO (CA)
  115. UC Irvine Health Accountable Care Organization (CA)
  116. UC San Diego Health Accountable Care Network (CA)
  117. UCSF Health ACO (CA)
  118. UMC Accountable Care (NM, TX)
  119. United Physicians ACO (MI)
  120. University Health ACO (TN)
  121. UPQC (NV, UT)
  122. Valley Medical Group-Renton (WA)
  123. VillageMD Chicago ACO (GA, IL, IN, KY, TN)
  124. White River Health System Clinically Int. Network (AR)
Thursday
Dec142017

Welcome, Comrade Patient

Welcome, Comrade Patient
 

By Kim Bellard, December 14, 2017

 

Capitalism is in big trouble, even in the U.S. and especially among millennials.  So reports Fast Company and The New York Times.  Even capitalism-friendly publications like The Wall Street Journaland Bloomberg warn about it. 

The oft-cited reasons include problems like increasing income/wealthy inequity and dimmer outlook for good jobs, but I have to wonder how much of a role our health care system plays in these kinds of attitudes.

 

The WSJ also showed a 2016 Gallop poll in which capitalism and socialism were rated equally favorably (both just over 50%) by respondents ages 18 - 29, which was a stark contrast to every other age group (support for capitalism goes up by age, while support for socialism declines).  Similarly, a 2017 WSJ/NBC News survey found that the 18-29 age group was much more likely to say the government should do more to help people, again in contrast to other age groups. 

In some ways, the U.S. health care system is a model of capitalism.  Lots of people are making lots of money, whether they be stockholders in health companiesdoctors and health care executives, or even supposedly non-profit parts of the system. 

The problem is, though, unless you are one of the lucky ones doing well with our current system -- and maybe even then -- you're probably not too happy with it. 

Last year, Senator Bernie Sanders made unexpected headway in his race to be the Democratic candidate for President despite -- or perhaps because of -- his socialist leanings.  One of his key planks was for Medicare for all, an idea that has seen a strong resurgence generally.  Even more popular is the (admittedly vague) push for single payor.

Harvard-Harris poll found that 52% of Americans supported a single payor system, with even 35% of Republicans supporting.  Young people were most supportive.   Perhaps most astonishing is that a Merritt-Hawkins survey found that 56% of physicians now support single payor, a sharp reversal from prior surveys.  42% voiced strong support.

Right now, millennials are not as engaged in health care as older age groups because they tend to need it less.  They don't have as many health problems and don't see health professionals as often.  That's why getting them to buy health insurance is a constant struggle, even when they have the lowest premiums.   

But as this radicalized generation, who are already frustrated with economic inequity and the prospects for their future, realize how much they will have to pay for older Americans' health needs as well as for their own, push will eventually come to shove. 

 

We have some hard thinking to do about how we finance health care, and for whom.  We have some hard thinking about what the role of profit, competition, and capitalism should be in our health care system.  We have some hard thinking to do about why our health care system is not serving more of us better.

It may not be socialized medicine.  It may not be single payor.  It may not even be Medicare-for-all.  But it for sure will not be what we have now. 

 

This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting

 
Monday
Dec042017

Reforms and Innovation Needed to Lower Costs and Improve Quality in Healthcare

Reforms and Innovation Needed to Lower Costs and Improve Quality in Healthcare
 

By: Tomas Gregorio, Senior Executive Director, Healthcare Delivery Systems iLab, New Jersey Innovation Institute

Healthcare in the United States is complicated, inefficient and expensive.  Many individuals and families can no longer afford to see a doctor, fill a prescription or get the most basic medical care without having to sacrifice other essential items such as putting food on the table or paying the mortgage.  These are choices that no American should be forced to make. 

Unfortunately, after seemingly endless attempts at reform, the costs of our healthcare system continue to move steadily higher, impervious to all attempts from the government, private companies or other stakeholders to hold back the ever-rising healthcare tide.

Healthcare, by its very nature, is resistant to change.  Concerns over privacy and safety often delay the sharing of information or adoption of new technologies that could reduce the costs of care. While these issues are valid, they can and must be addressed as the status quo is no longer acceptable.  

This point has not been lost on the U.S. Department of Health and Human Services and the West Health Institute that in a recent whitepaper noted that greater interoperability of healthcare devices alone could help save more than $30 billion a year in wasteful spending.  While the Rand Corporation in an earlier study estimated that full national interoperability could save $77 billion annually.

A national network in which all providers have access to medical records is still many years away however, there are steps being taken right now by the Centers for Medicare & Medicaid Services (CMS)  that promise to have a positive impact on healthcare costs and quality.   The initiatives, “Patients Over Paperwork” and “Meaningful Measures” seek to reduce the regulatory and reporting burden on providers.

Reducing the amount of time physicians spend on paperwork is goal that I am sure would garner 100 percent support in the healthcare community.  Providers spend countless hours filling out forms or checking boxes that in many cases have no obvious benefit for either the physician or the patient. 

Seema Verma, CMS Administrator, noted this problem during remarks on October 30, at a Healthcare Summit when she said, “We publish nearly 11,000 pages of regulations every year. That is a lot of paper, and it’s taking doctors away from what matter most – patients.”

Further, the American Hospital Association recently published a report showing that health systems, hospitals and post-acute care providers spend nearly $39 billion a year (let that sink in for a minute) solely on administrative activities.

CMS is beginning to address this problem by taking on a full scale review of current regulations by asking some very basic and important questions:  What is the purpose of the regulation? Does this regulation help prevent fraud and abuse? Does the regulation have a meaningful impact on patient care, safety and improving outcomes?   This review alone, and a subsequent role back of regulations has the potential to save untold billions of dollars, improve patient care and restore the sanctity of the provider/patient relationship.

CMS’ Measures Management effort is about examining what quality measures should be reported to the government as part of their overall goal of moving our healthcare system from fee-for-service to value-based care.

My organization, The New Jersey Innovation Institute (NJII), fully supports this effort and is partnering with CMS through their Transforming Clinical Practices Initiative (TCPI) that seeks to save more than $1 billion in healthcare costs by the end of 2019 by helping physicians adopt value-based care payment models. NJII has recruited a network of nearly 10,000 physicians to be part of the initiative and we are on pace to save more than $135 million in costs and improve the health of more than 500,000 Medicare patients over the life of the program.

Meaningful Measures will focus on having providers report only on measures that are most vital to providing high quality care and improving outcomes for patients.   In essence, CMS will focus more on results, less on process, and promote a more market driven health care system.

NJII applauds CMS in its efforts to bring innovation to our healthcare system and examine opportunities for advancement.   We encourage healthcare stakeholders at every level to bring their expertise to the table and further the collective effort to lower costs and improve healthcare quality.

 
Monday
Dec042017

The President’s Commission on Combating Drug Addiction and the Opioid Crisis

Sandhya Gardner, MD, Chief Medical Officer, Relias, December 4, 2017

There has been no shortage of attention given to the current opioid abuse and overdose epidemic sweeping the U.S. Near-daily media reports highlight the staggering number of people who are addicted to prescription and illicit opioids and who die from them daily. Nor have suggested remedies been neglected. Federal regulatory agencies, including the FDA and the CDC, professional medical associations, public health organizations, the insurance industry, and others have all recently issued new guidelines and policies on the proper administration of opioids and the treatment of individuals with opioid addiction.

Despite, or perhaps because of this attention, the President’s Commission report was eagerly anticipated. When released in final form on November 1, 2017, the report was widely praised for its comprehensive attention to the many factors that have combined to create the perfect storm that is today’s opioid crisis. There were reservations, however, because the Commission did not recommend any specific funding amounts to implement its recommendations. Moreover, President Trump’s decision to declare the opioid epidemic a public health crisis rather than a national health emergency also meant that no new funding has yet been allocated. The President’s Commission did advocate, however, that an unspecified amount of increased resources be put towards implementing its 56 recommendations.

We will highlight some critique and opinions about these recommendations specifically for healthcare providers and prescribers, organizations, funders and insurers, government and law enforcement agencies, and patients.

Providers and prescribers will see that the recommendations are largely extensions of current practice and therefore are relatively unsurprising. Adopting policies to ensure that patients give informed consent before receiving an opioid is consistent with current practice standards. Physicians should of course always discuss risks, benefits, and alternatives of any intervention they recommend for their patients. The concern here is that the informed consent procedure policies adopted be balanced. Opioids are proven effective analgesics for both acute and, in some instances, chronic pain and there are patients for whom they are clearly indicated. Informed consent procedures should, therefore, not be designed to frighten or discourage patients who need opioids.

Noteworthy, although not a departure from current policies and recommendations, is standardizing guidelines and extending them to specialists. Right now, there is a patchwork of opioid prescribing guidelines that have been created by multiple agencies. Many of them apply only to primary care providers. Currently, some states, like New York, have mandatory opioid continuing education requirements for relicensing and require that prescribers consult the state’s on-line Prescription Drug Monitoring Program (PDMP) before prescribing an opioid. These requirements would be extended to all states and a standardized national opioid prescribing curriculum would be created. It is unclear how effective continuing education programs are in improving opioid prescribing practices, so the benefits must be weighed against the burden it places upon physicians who must spend time taking more courses. Similarly, although there is some evidence that PDMP use reduces opioid abuse, it remains unknown whether this will have a significant effect in stemming opioid abuse.

Physician groups have complained that questions about how pain was handled that are included in patient satisfaction surveys contribute to unnecessary opioid prescribing. Fearing that negative reviews will be held against them; physicians report feeling pressured to prescribe opioids to patients with pain complaints to boost their ratings. The new recommendations mandate that CMS remove pain questions entirely from patient satisfaction surveys. This seems like a very positive step towards reducing inappropriate opioid prescribing.

Current practice is to refer patients reporting to the Emergency Department (ED) with signs and symptoms of opioid abuse or withdrawal to outpatient providers, but this can lead to poor follow-up and/or retention in treatment. Studies have shown that treatment, particularly with medications like buprenorphine/naloxone (Suboxone), can be started in the ED for such patients, who then are much more likely to enter outpatient treatment and remain drug-free for extended periods of time.  Although some emergency physicians in the past have been reluctant to start medication assisted treatment (MAT) for patients in the ED, the recommendation to initiate substance abuse and addiction treatment in the emergency department could substantially improve outcomes for opioid addicted individuals. 

Healthcare insurers will likely see an increase in their costs because of these recommendations. Nevertheless, these recommendations are all consistent with expert opinion. Right now, insurers incentivize physicians to prescribe opioids rather than alternative analgesic interventions, a policy that is widely criticized. For example, it is less expensive for patients to fill a prescription for a generic opioid than it is to have acupuncture or cognitive-behavioral therapy, even though both of the latter are among the non-opioid interventions that can be effective and far less risky in treating pain than opioids. The President’s Commission appropriately recommends modification of rate-setting policies that discourage use of non-opioid treatments for pain. It also calls for insurers to remove barriers for all forms of substance use disorder (SUD) treatment, including MAT. There is widespread agreement among experts that MAT is a safe and effective treatment for SUD and that its use should be expanded significantly. Finally, the recommendations call for stricter enforcement and stiffer penalties for insurers that violate mental health and parity laws. Although this last recommendation will certainly win the approval of advocates, enforcing the parity laws currently in effect has proven to be extremely difficult.

The creation of drug courts in all 93 federal judicial districts has already won widespread approval. Individuals with an SUD who violate parole would be referred to a drug court rather than sent to prison. Sending SUD patients to prison is generally seen as counterproductive and diversion to treatment via drug courts reduces recidivism.

Of course, all the above will have tremendous impact on patients who have pain-related illnesses or who are struggling with problematic opioid use. One recommendation that has not been met with much approbation, however, is for a media campaign to address “the hazards of substance use, the danger of opioids, and the stigma.” Some have criticized this recommendation as being too vague. It is unclear that such a campaign would significantly alter public perception or behavior. It also runs the risk of discouraging people who are legitimately taking opioids for severe pain, such as cancer patients, from adhering to prescribed regimens. The hope is that if a media campaign is pursued, that it is carried out in an evidence-based manner that incorporates what is known from social science about effective methods for changing attitudes and behavior.

Conclusions:

The most immediate concern about the President’s Commission report is that no funding is yet attached to its recommendations. One member of the Commission, former Rhode Island congressman Patrick Kennedy, was quoted as estimating that Congress needs to appropriate at least $10 billion immediately for the Commission’s recommendations to be carried out.   

Another concern is whether the President’s Commission report takes into consideration the need to balance medically-indicated opioid prescribing with abuse/overdose prevention. Opioids are effective analgesics that can be a highly appropriate treatment for severe pain in both acute and chronic situations. But there is no question that they are currently prescribed in many situations for which other, less perilous, alternatives are effective and available. Nor is there any disagreement that opioid misuse and abuse have reached epidemic proportions and that the quantity of opioids prescribed must be reduced. However, patients who need to take opioids must not be stigmatized, nor must physicians be frightened to prescribe them when its necessary.

Overall, barring the concerns about funding and some skepticism around the proposed media campaign, the recommendations have been met with optimism. They provide a multi-prong approach to an enormous problem and include many evidence-based recommendations.

For further information on this topic, a free webinar will be taking place on Tuesday, December 12 at 2pm EST. Titled, Opioid Commission Final Report: Recommendations and Effects on Payers, Insurers, and Providers, the webinar will be led by Susan Kansagra, MD, MBA – Section Chief -  North Carolina Division of Public Health, Chronic Disease and Injury Section, North Carolina Department of Health and Human Services, and Jason E. Vogler, Ph.D., CS SBB, Senior Director - Division of Mental Health, Developmental Disabilities and Substance Abuse Services
North Carolina Department of Health and Human Services. Registration for the webinar is available here.