PATIENTS WHO ARE PRIVATELY INSURED RECEIVE

LIMITED FOLLOW-UP SERVICES AFTER OPIOIDRELATED HOSPITALIZATIONS

AUTHORS

Mir M. Ali, Ph.D., and Ryan Mutter, Ph.D.

INTRODUCTION

Opioid misuse is a growing public health concern.1 Nearly 2.4 million people in the United

States have a substance use disorder (SUD) related to prescription opioids. Approximately a

half million people have an SUD related to heroin.2 There has been a significant increase in

hospitalizations for opioid misuse.3,4 The U.S. Food and Drug Administration has approved

three different medications to treat opioid addiction: methadone, naltrexone, and

buprenorphine.5 Research shows a combination of medications and therapy is often the most

successful approach to treating opioid addiction.6,7

The Truven Health Analytics MarketScan® Commercial Claims and Encounters Database

includes insurance claims from employees and their dependents covered by large, selfinsured employers and by regional health plans. The MarketScan Database captures all

billed services, including prescription drugs, outpatient services, and inpatient services. This

report uses data from 2010 to 2014. Information on MarketScan is available online at

http://truvenhealth.com/your-healthcare-focus/analytic-research/marketscan-research-datab

ases

● Data on privately insured individuals aged 18 to 64

from the 2010 to 2014 Truven Health Analytics

MarketScan® Commercial Claims and Encounters

Database show that 40.0 percent of patients did

not receive any follow-up services within 30 days

following an opioid-related hospitalization.

● Only 10.7 percent of patients received the

recommended combination of both medication and

a therapeutic service within 30 days following an

opioid-related hospitalization.

● Within 30 days of discharge for an opioid-related

hospitalization, 6.0 percent of patients received

medications only, and slightly more than 43.3

percent received therapy only.

In Brief

Short Report February 11, 2016

Center for Behavioral Health Statistics and Quality
USE OF FOLLOW-UP SERVICES FOLLOWING AN OPIOID-RELATED HOSPITALIZATION

In 2014, more than 67 percent of Americans aged 18 to 64 had private insurance, making it the most common form of health care coverage in

the United States.8 Data on privately insured individuals aged 18 to 64 from the 2010 to 2014 Truven Health Analytics MarketScan® Commercial

Claims and Encounters Database show that 40.0 percent of patients did not receive any follow-up services within 30 days following an opioidrelated hospitalization (Figure 1). Within 30 days of discharge for an opioid-related hospitalization, 6.0 percent of patients received medications

only, and 43.3 percent received therapy only. A small percentage (10.7 percent) of patients received the recommended combination of both

medication and a therapeutic service.

Figure 1. Post-discharge services provided within 30 days following an

opioid-related hospitalization among the privately insured: 2010 to 2014

SUD = substance use disorder.

Source: Truven Health Analytics MarketScan® Commercial Claims and Encounters

Database, 2010-2014

DISCUSSION

Given the increasing rates of hospitalization for opioid misuse, identifying patterns of post-discharge treatment is an important step in

developing targeted prevention, intervention, and treatment options for patients with an SUD related to prescription opioids. More research is

needed to understand the barriers that patients with an SUD related to prescription opioids have in trying to access services after hospitalization,

as well as the barriers that health care providers have in making the optimal referral.
END NOTES

1. Volkow, N. (2014). America’s addiction to opioids: Heroin and prescription drug abuse. National Institute on Drug Abuse. Retrieved from

http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse

2. Center for Behavioral Health Statistics and Quality. (2014, September 4). Table 5.14A—Substance dependence for specific substances in the past year, by

age group: Numbers in thousands, 2012 and 2013 [Table]. In Results from the 2013 National Survey on Drug Use and Health: Detailed tables. Retrieved

from http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect5peTabs1to56-2013.htm#tab5.14a

3. Coben, J. H., Davis, S. M., Furbee, P. M., Sikora, R. D., Tillotson, R. D., & Bossarte, R. M. (2010). Hospitalizations for poisoning by prescription opioids,

sedatives, and tranquilizers. American Journal of Preventive Medicine, 38(5), 517–524.

4. Owens, P. L., Barrett, M. L., Weiss, A. J., Washington, R. E., & Kronick, R. (2014). Hospital inpatient utilization related to opioid overuse among adults,

1993–2012 (Statistical Brief #177). Retrieved from http://www.hcup-us.ahrq.gov/reports/statbriefs/sb177-Hospitalizations-for-Opioid-Overuse.pdf

5. Office of National Drug Control Policy. (2012). Medication-assisted therapy for opioid addiction. Retrieved from

https://www.whitehouse.gov/sites/default/files/ondcp/recovery/medication_assisted_treatment_9-21-20121.pdf

6. Fullerton, C. A., Kim, M., Thomas, C. P., Lyman, D. R., Montejano, L. B., Dougherty, R. H., & Delphin-Rittmon, M. E. (2014). Medication-assisted treatment

with methadone: Assessing the evidence. Psychiatric Services, 65(2), 146–157. doi: 10.1176/appi.ps.201300235

7. Liebschutz, J. M., Crooks, D., Herman, D., Anderson, B., Tsui, J., Meshesha, L. Z., & Stein, M. (2014). Buprenorphine treatment for hospitalized, opioiddependent patients: A randomized clinical trial. JAMA Internal Medicine, 174(8), 1369–1376.

8. Ward, B., Clarke, T., Freeman, G., & Schiller, J. (2015). Early release of selected estimates based on data from the 2014 National Health Interview Survey.

Retrieved from http://www.cdc.gov/nchs/fastats/health-insurance.htm

SUGGESTED CITATION

Ali, M. M., & Mutter, R. (2016). The CBHSQ Report: Patients Who Are Privately Insured Receive Limited Follow-up Services After Opioid-Related

Hospitalizations. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality.
SUMMARY

Background: There has been a significant increase in hospitalizations for opioid misuse in recent years. Identifying patterns of post-discharge

treatment is an important step in helping patients receive appropriate care following an opioid-related hospitalization. Methods: Using

2010–2014 data from the Truven Health Analytics MarketScan® Commercial Claims and Encounters Database, this report identifies the types of

services individuals with private insurance receive following hospitalization for opioid misuse. Results: Forty percent of patients do not receive

any follow-up services within 30 days after an opioid-related hospitalization. Only 10.7 percent of patients received the recommended

combination of both medication and a therapeutic service. Conclusion: Developing strategies to link patients to resources that can provide the

recommended treatment options is an important goal in supporting treatment and recovery efforts.

Keywords: substance use disorder treatment, opioid

AUTHOR INFORMATION

cbhsqrequest@samhsa.hhs.gov

KEYWORDS

Short Report, Client-Level Data, Emergency Department Data, 2010, 2011, 2012, 2013, 2014, Educators, Employers, HHS Staff, Media, People with Substance

Use or Abuse Problems as Audience, Policymakers, Public Officials, All US States Only

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency

within the U.S. Department of Health and Human Services that leads public health efforts

to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact

of substance abuse and mental illness on America's communities.

The CBHSQ Report is prepared by the Center for Behavioral Health Statistics and Quality

(CBHSQ), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI

International is a trade name of Research Triangle Institute.)

Other substance abuse reports:

http://www.samhsa.gov/data