Table 1 Participating health care organization characteristics
Health care organization | US census division | Location | No. of clinical sites†| Organization characteristics | Experience with opioid management | Opioid prescribing rate per 100 (county)* | Opioid OD death rate per 100,000 (state)** |
|---|---|---|---|---|---|---|---|
Org. 1 | Pacific | Rural | 4 | • Multispecialty group practice • Serves about 72,000 patients • Community hospital subsidiary | • Currently participating in Medicaid transformation project on 6BBs | 90.4 | 9.4 |
Org. 2 | Pacific | Urban | 13 | • Federally Qualified Health Center (FQHC) • Patient-centered medical home (PCMH) • Community-based nonprofit organization • Serves about 30,000 patients; over 50% of patients have Medicaid coverage | • Familiar with 6BBs • Has a system-wide, cross discipline policy including prescribing guidelines, refill policy, and MAT referrals/treatment • Interested in self-service approach to tweak what is already in place | 56.8 | 9.7 |
Org. 3 | Pacific | Urban | 1 | • University affiliated • Part of a health system • 50% of patients are racial/ethnic minorities | • Has done a lot of work but not streamlined • Has been developing opioid policy | 27.1 | 5.3 |
Org. 4 | Mountain | Urban | 1 | • Privately owned primary care practice • PCMH • Recognized as an exemplar practice by other initiatives | • Has conducted work around opioid management for years, including efforts to stratify patients according to opioid abuse risk | 47.2 | 9.5 |
Org. 5 | Mountain | Rural | 4 | • FQHC • PCMH • High percentage of patients on Medicare/Medicaid • 22 total clinic sites in the system | • Seeking alternative pain management practices for providers • Due to limited availability of pain management specialists, many primary care providers prescribe | 111.8 | 11.4 |
Org. 6 | East North Central (Midwest) | Urban | 6 | • FQHC • University affiliated • 80% of patients have Medicaid coverage | • Does not do a lot of new prescribing of opioids but faces challenges managing inherited patients on opioids | 37.2 | 15.3 |
Org. 7 | East North Central (Midwest) | Urban | 1 | • Hospital-owned, family medicine residency program • PCMH • Part of a health system | • Has worked on implementing components of the 6BBs including workflows, policies, and patient agreements | 61.8 | 32.9 |
Org. 8 | East North Central (Midwest) | Urban | 1 | • Residency clinic • University affiliated | • Has guidelines from hospital and some of the pieces already in place in the residency program • Current opioid education is focused on risk management | 50.1 | 32.9 |
Org. 9 | East South Central | Rural | 6 | • Regional hospital with outreach clinics. 16 total clinic sites in the system • PCMH | • Started an opioid stewardship committee and wants to include best practices in building this program • Has worked on policies and patient agreements and now wants to focus on tracking/monitoring. | 96.9 | 23.6 |
Org. 10 | Mid-Atlantic | Rural | 2 | • Graduate medical education safety-net consortium • Serves about 17,500 patients • PCMH • Part of a health system; 9 total clinic sites in system | • Has conducted prior work on opioid prescribing and aims to improve further | 97.3 | 18.5 |
Org. 11 | Mid-Atlantic | Urban | 1 | • Hospital-owned, family medicine residency clinic • Serves about 22,000 patients • University affiliated • Part of a health system | • Has worked on implementing components of the 6BBs for several years, but sees an opportunity to improve | 42.7 | 15.1 |