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CEO Update | 63

New Quality Summit to Assess HHS’ Quality Programs HHS Deputy Secretary Eric Hargan this week announced the department’s new Quality Summit, which will join government leaders and healthcare industry stakeholders to discuss how to adapt and streamline HHS’ current quality programs in a way that improves outcomes for patients. Hargan will co-chair the Quality Summit with Peter Pronovost, M.D., Ph.D., an internationally renowned expert on healthcare quality and patient safety. In March, Hargan discussed the regulatory barriers that often hinder treatment during his presentation at the 2019 NABH Annual Meeting in Washington. “Over the last decade we have seen efforts by HHS to incentivize the provision of quality care, only to be met with limited success,” Hargan said in a news release. “This is in part because patients have not been empowered with meaningful or actionable information to inform their decision making. At the same time, important quality programs across the department have remained uncoordinated among the various agencies and inconsistent in their demands on healthcare providers,” he added. “We believe the Quality Summit will not only strengthen the protections these programs afford patients, but also improve value by reducing costs and onerous requirements that are placed on providers and ultimately stand between patients and the high-quality care they deserve.” Late last month, President Trump signed the Improving Price and Quality Transparency in American Healthcare to Put Patients First executive order, which directs federal agencies to develop a Health Quality Roadmap intended to align and improve reporting on data and quality measures across federal health programs. OIG Report Finds Opioid Use Decreased and MAT Increased Among Medicare Part D Beneficiaries A new report from HHS’ Office of Inspector General (OIG) found a significant decrease in the number of Medicare Part D beneficiaries who received opioids in 2018 and a steady increase in the number of beneficiaries who received drugs for medication assisted treatment (MAT). Nearly three in 10 Medicare part D beneficiaries received opioids in 2018, the OIG reported, while at the same time the number of beneficiaries who received MAT for opioid use disorder reached 174,000. Meanwhile, about 354,000 beneficiaries received high amounts of opioids in 2018, with about 49,000 of them at serious risk of opioid misuse or overdose—which was also fewer than in the previous two years. “Progress has been made in decreasing opioid use in Part D, increasing the use of drugs for medication assisted treatment, and increasing the availability of naloxone,” the OIG reported noted. “It is imperative for the Department of Health and Human Services— including CMS (Centers for Medicare and Medicaid Services) and OIG— to continue to implement effective strategies and develop new ones to address this epidemic.” O’Neill Institute Evaluates Democratic Candidates’ Views on Addiction and Opioid Crisis The O’Neill Institute at Georgetown Law this week released an analysis of the 2020 Democratic presidential candidates’ plans to address America’s continued opioid crisis. In a post on the O’Neill Institute’s webpage this week, authors Regina LaBelle—a 2019 NABH Annual Meeting speaker—and Leigh Bianchi noted that most all of the presidential candidates have not issued detailed policy proposals on the topic. Instead, their positions on the issue were taken from statements at campaign events and from their record in public office. LaBelle and Bianchi categorized the candidates’ positions by federal officials, state and local officials, and other candidates. Click here to read their analysis. SAMHSA and CMS Issue Joint Bulletin on Addressing Mental Health and SUD in Schools The Substance Abuse and Mental Health Services Administration (SAMHSA) and CMS this week issued a joint information bulletin that describes Medicaid mandatory and optional state plan benefits and other Medicaid authorities states may use to cover mental health and substance use disorder (SUD) treatment for children in schools. The bulletin includes tools and resources to help states, educational agencies, and healthcare providers work together to identify and treat students’ mental illness or substance-related challenges in school-based settings. It also outlines best practices to help implement quality, evidence-based, and comprehensive mental illness and substance use-related services for students. Included in the 28-page bulletin are specific examples of state-level strategies for Medicaid and other financing of school-based mental health services. Study Examines Association of Nonmedical Prescription Opioid Use with Heroin Use Initiation in Adolescents A study published in JAMA Pediatrics this week found that nonmedical prescription opioid use was prospectively associated with subsequent heroin use initiation during four years of adolescence among youth in Los Angeles. Researchers conducted an eight-wave cohort study of 14-year-old and 15-year-old high school students in Los Angeles who had never used heroin at baseline and found that youth reporting no, prior, and current nonmedical prescription opioid use during high school showed estimated “cumulative probabilities” of subsequent heroin use initiation by the end of the 42-month follow-up of 1.7 percent, 10.7 percent, and 13.1 percent, respectively. The reason for the study stemmed from the concern that nonmedical prescription opioid use is associated with increased risk later of heroin use initiation among adolescents but that longitudinal data addressing this topic are lacking. The study’s authors noted that future research is needed to determine whether this association is causal. House Energy and Commerce Subcommittee Hearing Will Examine Spread of Illicit Fentanyl The House Energy and Commerce Subcommittee on Oversight and Investigations will host a hearing next Tuesday, July 16 to examine the increasing threat of illicit fentanyl. The hearing announcement noted recent statistics from the Centers for Disease Control and Prevention that show there were more than 47,000 drug overdose deaths involving opioids in 2017, of which 28,000 involved synthetic opioids such as fentanyl—a nearly 47-percent increase from the prior year. Tuesday’s hearing will feature witnesses from the key federal agencies responding to the nation’s opioid crisis. CMS to Host Webinar on QIOs and IPFs Working Together to Reduce Readmissions Quality experts from CMS and quality improvement organization MPRO will lead a webinar for participants in the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program next Thursday, July 18 at 2 p.m. ET. Christina Goatee, M.S.N., R.N. from CMS and Barbra Link, L.M.S.W., CIRS-A/D from MPRO will lead the hourlong webinar, Quality Improvement Organizations and Inpatient Psychiatric Facilities Working Together to Reduce Readmissions, to provide an overview of the Quality Improvement Organization (QIO) program and show how collaborative relationships with QIOs can reduce inpatient psychiatric facility readmissions and enhance outcomes. Click here to register.   For questions or comments about CEO Update, please contact Jessica Zigmond.