Limiting Opioid Overprescription after Prostatectomy: How Payer-Provider Collaboration Can Lead to Improved Patient Safety and Reimbursement

Document Type

Article

Publication Date

4-15-2020

Publication Title

NEJM Catalyst Innovations in Care Delivery

Abstract

Blue Cross Blue Shield of Michigan (BCBSM) has a history of working with health care providers to improve quality of care and value through its Collaborative Quality Initiatives program. The Michigan Urological Surgery Improvement Collaborative (MUSIC) is a consortium of 44 urology practices and more than 250 urologists, both academic and private, which maintains a prospective registry of validated clinical data in partnership with BCBSM. Through this collaboration, a multidisciplinary pain-control optimization pathway was created and implemented, resulting in a significant decrease in the number of opioid tablets prescribed after robotic prostatectomy while increasing reimbursement of professional fees for the procedure by 35% though the use of a modifier code.

Volume

1

Issue

3

DOI

10.1056/CAT.20.0140

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