States Should Make Data on Opioid Use Disorder Treatment Easy to Access

Such information can help identify treatment gaps, improve outcomes

Article By: Frances McGaffey
Projects: Substance Use Prevention and Treatment
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States Should Make Data on OUD Treatment Easy to Access
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Most states collect and report at least one core opioid use disorder (OUD) treatment measure that can be used to improve state treatment systems and save lives. It is crucial that states publicly report such health data—doing so has been linked to improved clinical outcomes.

However, finding and interacting with data on OUD treatment measures can be challenging because very few states share data in a format that is easily accessible, such as interactive dashboards. In fact, Pew reviewed the existing opioid dashboards, commonly used to track overdose deaths, of 46 states and found that as of spring/summer 2023:

Ten states report on any of the core OUD treatment measures in their dashboards (see Table 1). Just one state—Alabama—reports via dashboard on all seven core OUD treatment measures.

Table 1

Few States Report on Any Core OUD Treatment Measures via Interactive Dashboards

OUD diagnosis Assessed for SUD using a standardized screening tool Use of pharmacotherapy for OUD* OUD provider availability Continuity of pharmacotherapy for OUD ⴕ Initiation of OUD treatment and engagement in OUD treatmentǂ Follow-up after an emergency department visit for substance use§
Alabama ⚫ ⚫ ⚫ ⚫ ⚫ ⚫ ⚫
Kentucky ⚫ ⚫
New Hampshire ⚫
Ohio ⚫ ⚫ ⚫ ⚫ ⚫
Pennsylvania ⚫
South Carolina ⚫
Vermontǁ ⚫
Virginia ⚫ ⚫
Washington ⚫
Wisconsinǁ ⚫

Note: The table shows states that report the core OUD treatment measures on their dashboard. These findings were identified through a review of 46 states’ existing dashboards as of December 2022 (Georgia, Iowa, Mississippi, Nebraska, and the District of Columbia did not have dashboards available for review) with a few exceptions listed in the attached file. As such, states may be reporting on the above measures through other publicly available resources, such as annual state agency reports, but this information is not captured in the table.

* Use of pharmacotherapy for OUD refers to the National Committee for Quality Assurance (NCQA) National Quality Forum (NQF) measure 3400.

ⴕ Continuity of pharmacotherapy for OUD refers to NQF measure 3175.

ǂ Initiation of OUD treatment and engagement in OUD treatment refer to NQF measure 0004, stratified for OUD. This is a Healthcare Effectiveness Data and Information Set (HEDIS®) measure, a registered trademark of NCQA.

§ Follow-up after an emergency department visit for substance use is a HEDIS® measure and refers to NQF measure 3488.

ǁ Vermont only reports on initiation of OUD treatment, not engagement, in the state’s dashboard. Wisconsin reported on use of pharmacotherapy for OUD as a general data point rather than by medication type, as specified by the measure developers.

More states should publicly share via dashboard the full set of measures to demonstrate to their constituents, including people with OUD and their loved ones, a commitment to creating a high functioning treatment system that keeps people alive and on a path of recovery. Promoting a common understanding of a treatment system’s strengths and gaps can guide efforts to increase access and improve outcomes.

States can report the core OUD treatment measures many already collect in a user-friendly way by either integrating the measures into their existing opioid dashboards or following Alabama’s lead and creating a separate dashboard to report the measures.

Many of the states sharing the data focus on the Medicaid-enrolled population. However, states with all-payer claims databases, which centralize information from at least some of the commercial insurers operating in the state, can also include data on treatment for people with this type of coverage to provide a more comprehensive picture. For example, New Hampshire reports the OUD diagnosis rate for both Medicaid and commercially insured populations.

Although Pew found that only a few states report on any core OUD treatment measures in their dashboards, many reported other relevant measures that could also help improve a state’s treatment system. For example, a non-exhaustive review of state opioid dashboards found that at least 11 states report on opioid-involved emergency department (ED) visits. Although not a core OUD treatment measure, this information is critical to tracking a state or county’s overdose rates and locations as well as understanding how many people are in contact with EDs, which could serve as an opportunity to engage patients in further care. Adding the core OUD treatment measures to these dashboards would help these states understand how many people receive follow-up care after they visit an ED, and how well the related treatment system they enter is performing.

Disaggregating data makes it actionable

When states disaggregate, or break out, their data by geography or demographic factors such as race and ethnicity, they make it possible to develop targeted solutions to meet the needs of diverse populations.

Ohio has done that by reporting five critical OUD treatment measures—including diagnosing OUD, assessing for substance use disorder using a standardized screening tool, using pharmacotherapy for OUD, continuing pharmacotherapy for OUD, and following up after an ED visit for OUD—at the county level. Doing so allows local decision-makers to act on this data. As Ohio Governor Mike DeWine noted after expanding the dashboards to the state’s 88 counties, it “provides invaluable data that will allow local organizations and communities to better plan for their needs as they battle this public health crisis in our state—and ultimately save lives.”

And although North Carolina does not report the core OUD treatment measures in their dashboard, it does share relevant data such as overdose deaths disaggregated by race and ethnicity. The dashboard also includes a county-level breakdown of overdose deaths by race and ethnicity. Such reporting of data by demographic factors can help inform efforts to ensure equitable access to treatment for people with OUD.

Other states should follow Ohio and North Carolina’s lead and strive to report the core OUD treatment measures with a geographic and demographic breakdown in an accessible manner. Without this information at hand, state and local decision-makers cannot make informed decisions to effectively target resources and improve treatment for people with OUD.

Methodology

To conduct this analysis, the research team reviewed publicly available, regularly updated interactive dashboards. (Static sources such as PDF files were excluded.) The team identified state dashboards using the Carolina Center for Health Informatics or a Google search. Results were verified by state behavioral health and Medicaid agencies between April and August 2023. After several outreach attempts, the research team had received responses from all states except Alaska, Iowa, South Carolina, and West Virginia.

Vanessa Baaklini is a senior associate and Frances McGaffey is an associate manager working on The Pew Charitable Trusts’ substance use prevention and treatment initiative.