Medicare Data Analysis Data Medicare Provider Utilization and

Medicare Data Analysis

Data • Medicare Provider Utilization and Payment Data: Part D Prescriber • Individuals prescribed drugs via Medicare Part D health care plan • Individuals above the age of 65 • Individuals with permanent disabilities • Individuals with end-stage renal disease

Findings: Vermont vs Rest of New England In 2014: Vermont an outlier compared to 5 other New England states for opioid scripts/beneficiary Well above average for opioid days supplied/beneficiary Opioid Days Supplied Per Beneficiary by State Opioid Scripts Per Beneficiary by State 80, 00 3, 50 3, 20 3, 00 2, 50 2, 842, 802, 81 2, 632, 67 3, 30 3, 17 2, 822, 752, 82 2, 622, 66 70, 00 2, 892, 84 2, 702, 72 60, 00 Series 1 Series 2 2, 00 Series 3 Series 4 1, 50 Series 5 1, 00 Series 6 50, 00 Vermont 17% higher than other NE states 64, 15 60, 09 59, 43 56, 78 Series 1 Series 2 Series 3 58, 91 57, 49 59, 02 Series 5 Series 6 20, 00 3 62, 77 59, 40 58, 46 55, 33 70, 33 Series 4 30, 00 10, 00 2 63, 76 59, 58 59, 16 55, 71 68, 27 40, 00 0, 50 1 69, 09 1 2 3 Vermont 10 days longer than other NE states

Findings: 2013 to 2014 From 2013 to 2014: Doctors increase rate of opioids prescribed and number of days supplied Opioid Days Supplied Per Beneficiary 2013 -2014 Scripts Per Beneficiary 2013 to 2014 80 3, 5 3 3, 20 3, 14 3, 17 3, 10 3, 30 3, 22 70 69, 09 67, 60 60 2, 5 68, 27 66, 44 70, 33 68, 52 50 2 Series 1 Series 2 1, 5 1 Series 1 40 Series 2 30 20 0, 5 10 0 0 1 2 3 11, 000 (9%) more opioid scripts in 2014 1 2 3 1. 5 days longer supply periods in 2014

Findings: By Specialty Across States In 2014: Vermont Doctors compared to the average for their peers within specialty across other New England states (where difference is stat. sig) Opioid Scripts Per Beneficiary 2014 (p<. 05; VT prescriber n>100) Opioid Days Supplied Per Beneficiary 2014 (p<. 05; VT prescriber n>100) 4 3, 5 90 80 3, 62 3, 44 3, 28 3 3, 13 80, 08 75, 76 70 3, 00 VT 2 Other NE States 1, 5 72, 53 64, 15 60 2, 66 2, 5 80, 55 56, 71 50 VT 40 Other NE States 30 1 20 0, 5 10 0 1 2 3 5% diff. 16% diff. 13% diff. 0 1 6% diff. 2 11% diff. 3 13% diff.

Findings: Prescriber Outliers

Limitations/Implications • Medicare Part D covers 14% of insured Vermonters • Findings may not be generalizable to entire population of Vermonters receiving prescription drugs • But could be indicative of wider practices • Offers glimpse into population that might be at risk for opioid addiction • Highlights the importance of further transparency in public health • Data only available through 2014 • Demonstrates the need for more timely public health data releases • Why we should push for more inclusive, timely public health prescription data: • Generate public discourse about opioid prescribing practices • Give doctors the opportunity to compare their practices to those of their peers • Allow for monitoring of progress in prescribing practices