The agency must create concrete measure to determine the breadth of patient treatment access for opioid addiction.
As a part of its efforts to combat the opioid epidemic, HHS has worked to expand patient access to treatment for opioid misuse. However, the agency has not adopted adequate measures to assess the success of medication-assisted treatment access, according to a recent report from the Government Accountability Office.
MAT combines both behavioral therapy and use of medications primarily methadone and buprenorphine – to combat opioid misuse and eventual addiction. The therapy has proven very effective in combating the opioid crisis, GAO said.
HHS created numerous grants to expand access to MAT, including four grants targeting high-needs regions.
“Grant recipients can use funding to undertake a range of activities, such as hiring and training providers and supporting treatments involving MAT,” GAO explained in its report. “In addition, certain providers and grant recipients are required to develop plans for preventing MAT medications from being diverted for nonmedical purposes.”
HHS also made regulatory changes that expanded the number of patients able to receive buprenorphine prescriptions. Those regulatory changes authorized nurse practitioners and physician assistants to prescribe buprenorphine.
These efforts have been underway since 2015, GAO reported.
During GAO’s investigation, HHS told the agency that it has not yet collected all of the data necessary to assess the program. As of August 2017, HHS was still finalizing how it would assess its own efforts to address the opioid epidemic.
Currently, HHS plans to evaluate the success with which it rolled out plans to address the opioid epidemic. The agency said in the future it may also assess how far it expanded MAT access.
These plans continue to prove insufficient, GAO found.
“While HHS has some of the information that could be used in a future evaluation of the effectiveness of its efforts to expand access to MAT, it has not adopted specific performance measures with targets specifying the magnitude of the increases HHS hopes to achieve through its efforts to expand access to MAT, and by when,” GAO wrote.
For example, HHS has not determined what percent increase it would like to hit as a part of its MAT expansion efforts. Such a measure would help HHS determine whether enough providers are prescribing MAT medications.
“HHS has also not chosen a specific method of measuring treatment capacity or established targets associated with it, which would help determine whether a sufficient number of providers are becoming available to evaluate and treat patients who may benefit from MAT,” GAO reported.
Not determining concrete improvement goals could be detrimental for HHS efforts to combat the opioid crisis, GAO posited.
“Without specifying these performance measures and associated targets, HHS will not have an effective means to determine whether its efforts are helping to expand access to MAT or whether new approaches are needed,” GAO stated. “Gauging this progress is particularly important given the large gap identified nationwide between the total number of individuals who could benefit from MAT and the limited number who can currently access it based on provider availability.”
GAO also found that HHS has not created a specific timeline for establishing measurement goals and carrying out the program assessment, which considerably hinders the agency’s ability to carry out these assessments.
GAO recommended HHS take two action steps to alleviate these issues. First, GAO suggested HHS establish performance benchmarks targeted specifically to patient access to MAT therapies.
Second, GAO advised that HHS create timeframes in which HHS would carry out these assessments to ensure the agency performs the assessments expeditiously.
In addition to identifying opioid epidemic efforts from HHS, GAO also uncovered efforts across the industry.
All of the states included in the GAO report cited plans or current strategies to implement MAT into primary care, thus helping to expand access to all patients.
On a health payer level, GAO found that some insurers have removed prior authorization requirements that have previously hindered patient access to MAT medications.
Nationally, healthcare associations are training their members for carrying out patient assessments. This will help organizations target patients who could benefit from MAT therapies, ensuring that resources are spent on the right populations.
Date: Nov 01, 2017