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    Research Letter
    Health Policy
    January 3, 2020

    Participation in a Hospital Incentive Program for Follow-up Treatment for Opioid Use Disorder

    Author Affiliations
    • 1National Clinician Scholars Program, University of Pennsylvania, Philadelphia
    • 2Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
    • 3Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
    • 4Penn Injury Science Center, University of Pennsylvania, Philadelphia
    • 5Office of Medical Assistance Programs, Department of Human Services, Commonwealth of Pennsylvania, Harrisburg
    • 6The Hospital and Healthsystem Association of Pennsylvania, Harrisburg
    • 7Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
    JAMA Netw Open. 2020;3(1):e1918511. doi:10.1001/jamanetworkopen.2019.18511

    Pennsylvania experienced an 80% increase in emergency department (ED) visits for opioid overdose from 2016 to 2017.1 The engagement of patients with opioid use disorder (OUD) in treatment after hospital discharge is a key strategy in preventing subsequent opioid overdose.2,3 The Pennsylvania Department of Human Services established an incentive program to improve the rate of OUD follow-up treatment among Medicaid recipients.4 In the Opioid Hospital Quality Improvement Program, hospitals earned payment for designing and attesting to 4 distinct clinical pathways: (1) ED initiation of buprenorphine treatment, (2) warm handoff to community resources, (3) referral and treatment for pregnant patients, and (4) inpatient initiation of medication treatment. Payment of the full incentive ($193 000) was contingent on participation and attestation of all 4 pathways, with smaller incentives for partial participation. We evaluated participation in this program among hospitals.

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