Evidence map›Paper›PMID 36243141›Full record

ArticleUrology2023

Less is More: Fulfillment of Opioid Prescriptions Before and After Implementation of a Modifier 22 Based Quality Incentive for Opioid-Free Vasectomies.

Catherine S Nam, Yen-Ling Lai, Hsou Mei Hu, Arvin K George, Susan Linsell, Stephanie Ferrante, Chad M Brummett, Jennifer F Waljee, James M Dupree

Open access · greenAbstract read
In one paragraph

Article in Urology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Catherine S NamDepartment of Urology, Michigan Medicine, Ann Arbor, MI.
Yen-Ling LaiDepartment of Surgery, Michigan Medicine, Ann Arbor, MI; Michigan Opioid Prescribing and Engagement Network, Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
Hsou Mei HuDepartment of Surgery, Michigan Medicine, Ann Arbor, MI; Michigan Opioid Prescribing and Engagement Network, Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
Arvin K GeorgeDepartment of Urology, Michigan Medicine, Ann Arbor, MI; Michigan Urological Surgery Improvement Collaborative, Ann Arbor, MI.
Susan LinsellDepartment of Urology, Michigan Medicine, Ann Arbor, MI; Michigan Urological Surgery Improvement Collaborative, Ann Arbor, MI.
Stephanie FerranteDepartment of Urology, Michigan Medicine, Ann Arbor, MI; Michigan Urological Surgery Improvement Collaborative, Ann Arbor, MI.
Chad M BrummettMichigan Opioid Prescribing and Engagement Network, Institute for Healthcare Policy and Innovation, Ann Arbor, MI; Department of Anesthesiology, Michigan Medicine, Ann Arbor, MI.
Jennifer F WaljeeDepartment of Surgery, Michigan Medicine, Ann Arbor, MI; Michigan Opioid Prescribing and Engagement Network, Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
James M DupreeDepartment of Urology, Michigan Medicine, Ann Arbor, MI. Electronic address: jmdupree@med.umich.edu.
Michigan Medicine · USInstitute for Healthcare Improvement · US

Funding

University of Michigan Fibromyalgia CORTP50AR070600 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CLAUW, DANIEL J · 2016 to 2021
$7.4M
oPIOIDS: Prevention of Iatrogenic Opioid Dependence after SurgeryR01DA042859 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BRUMMETT, CHAD M, WALJEE, JENNIFER FILIP · 2017 to 2021
$3.6M
Quantifying the Impact of Insurance Coverage for IVF on Maternal and Infant HealthR01HD103603 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DUPREE, JAMES M · 2021 to 2025
$2.3M
NIAMS NIH HHS P50 AR070600NICHD NIH HHS R01 HD103603NIDA NIH HHS R01 DA042859
6 · The paper itself

Abstract

objectiveTo examine the percentage of patients who filled peri-procedural opioid prescriptions before and after Blue Cross Blue Shield of Michigan (BCBSM) launched a modifier 22 payment incentive for opioid-sparing vasectomies in Michigan on July 1, 2019.

methodsWe evaluated BCBSM administrative claims data from February 1, 2018 - November 16, 2020 for men 20 - 64 years old who underwent vasectomy or a control office-based urologic procedure (cystourethroscopy, prostate biopsy, circumcision, and transurethral destruction of prostate tissue.) The primary outcome was the percentage of patients who filled opioid prescriptions 30 days before to 3 days after their procedure. We performed an interrupted time series analysis to estimate changes in the percentage of patients who filled opioid prescriptions in the vasectomy and control group before and after July 1, 1019.

resultsOur cohort included 4,559 men who had a vasectomy and 4,679 men who had a control procedure. Within each group, demographics and clinical factors were similar before and after July 1, 2019. Before implementation of the modifier 22 policy, 32.5% of men who had a vasectomy filled an opioid prescription whereas only 12.6% of men filled an opioid prescription after July 1, 2019 -a 19.9% absolute reduction and 61.0% relative reduction (P < .001). In the control group, there was no significant change in the percentage of patients who filled opioid prescriptions before and after July 1, 2019 (0.8% absolute increase, P = .671).

conclusionImplementation of modifier 22 based financial incentive for opioid-sparing vasectomies was associated with decrease in the percentage of men who filled opioid prescriptions after vasectomy.

Indexed as

Analgesics, OpioidVasectomyAdultDrug PrescriptionsHumansMaleMiddle AgedMotivationPostoperative PainPractice Patterns, Physicians'Young AdultAnalgesics, Opioid

Identifiers

PMID36243141
PMCPMC11424010
OpenAlexW4304889763

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.