August 3, 2017
To: CEOs, CMOs, COOs, government affairs staff of WSHA hospitals and health systems and Accountable Community of Health Executive Directors
Please forward to: Hospital and health system staff, clinicians and ACH staff leading work on addressing the opioid crisis
From: Ian Corbridge, RN, Clinical Policy Director
Staff Contact: Ian Corbridge, RN, Clinical Policy Director, ianc@wsha.org, 206-216-2514
Subject: Potential ACH Strategies for Providers Addressing the Opioid Crisis
Purpose
The purpose of this bulletin is to offer a set of strategies that can help hospitals, health systems, and independent/group practices and Accountable Communities of Health (ACH) address the opioid crisis. These six strategies offer promising interventions that can be implemented as part of the Medicaid demonstration opioid project – Project 3A.
Recommendation
We urge hospitals and health systems to engage with their ACHs on efforts to address the opioid crisis and support appropriate prescribing. Hospitals, health systems and providers should be in discussion with their ACHs about priorities and what system supports or resources they need to address the goals outlined in the Medicaid demonstration. Review the six strategies here to determine the ones that may be important and appropriate in your community.
Six Strategies for Hospitals, Health Systems, and Independent/Group practices:
- Overdose Prevention – Implementing protocols and policies in the ED and primary care setting for overdose education and take home naloxone for at-risk individuals;
- Expanding Access to Treatment – Initiating medication assisted treatment (MAT) in emergency departments and coordinating outpatient treatment for at-risk individuals;
- Integrating PMP Data into Clinical Workflows – Furthering utilization of the Prescription Monitoring Program (PMP) and integration of PMP data into EMR;
- Expanding Access to Treatment – Developing and implementing a tool kit to support providers in increasing the number of patients treated with MAT;
- Improving Opioid Prescribing Practices – Leveraging data and guidelines to support appropriate opioid prescribing practices; and
- Develop Low-Barrier Methadone and Buprenorphine Access – *under development.
Overview
ACHs are being asked to submit applications by November outlining their strategies for transformation under the Healthier Washington demonstration. To assist the ACHs and their providers, the Washington State Hospital Association and the Washington State Medical Association convened subject matter experts to identify promising strategies for hospitals, health systems, and independent/group practices to address the opioid crisis. We hope that hospitals and health systems will discuss these strategies with their ACHs and that ACHs will implement many of these approaches. We believe the impact will be stronger by having work aligned across regions.
While each strategy can stand on its own, we envision that hospitals, health systems and ACHs will want to couple individual strategies and supporting data to form a comprehensive opioid strategy focused on prevention, appropriate prescribing and access to treatment. Resources from the Medicaid demonstration work will assist in driving these important changes through new funding available for planning, training, and implementing changes to opioid prescribing and treatment. This work is expected to start soon, with implementation for participating providers required by October 2019.
Next Steps
As with other components of the ACH work, we fully expect these strategies to evolve and become more tightly calibrated over time. We recognize that much of the work on applications is starting now and we wanted to offer our suggestions in a timely manner for consideration as ACHs begin their drafting. We welcome your feedback on how these strategies can be improved. We will continue to work with subject matter experts to refine these strategies and will provide updates when available.
