Kennan Comments on Upcoming Changes with Opioid Bill

October 24, 2018

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In an Oct. 18 article from the Healthcare Financial Management Association, Stephanie Kennan, senior vice president with McGuireWoods Consulting, provided insights on expected changes once the SUPPORT for Patients and Communities Act is implemented.

Several changes involve the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which currently is a component of some value-based payment programs and is a factor on the hospital star ratings on Hospital Compare, a publicly available site. The legislation bars questions about pain-related communication by hospital staff with patients, unless the questions focus on informing about opioid risks and non-opioid alternatives.

“There has been such an emphasis on pain and pain management in hospitals that if HCAHPS surveys don’t include the question, it will be interesting to see how many patients start complaining that they are in pain,” said Kennan.

Other provisions within the legislation include a comprehensive screening for Medicare patients during the “Welcome to Medicare” visits, but patients must opt in to have the screening.

“Some patients you will want to get won’t necessarily want to opt in,” Kennan said. “Nonetheless, that is a really key provision because the Medicare population is a key group that hasn’t always had a lot of attention paid to it in the epidemic.”

Additionally, the bill includes provisions to help expand provider capacity to treat opioid-use disorders, allows states to seek waivers for federal funding to treat substance abuse at institutions for mental disease (IMDs), and expands the use of telemedicine for substance use treatment in Medicare.

The final legislation does not include a change to rules to ease provider exchange of information related to patients’ substance use disorders.

The current rules were “something that a number of providers and hospitals had been saying made it harder for them to treat,” Kennan said. “There was a number of people, including hospitals, that were concerned about the way they wanted to fix that. So that’s still hanging out there as an issue for providers.”