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Spreading Innovations in Health Care Delivery

This website, endorsed by Maryland’s Stakeholder Innovation Group, offers a glimpse at how many of Maryland’s health care providers and community organizations are working together to improve care delivery.

We urge you to use this site to share innovative programs and practices that improve the health of Maryland’s communities.

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Opioid Reduction Program

  • What are the objectives of the program?

    Improved health outcomes, Reduced spending

  • Please provide a brief description of the program:

    Anne Arundel Medical Centers surgical community understands and takes seriously the link between opioid prescribing and opioid addiction. AAMC studied its emergency room, primary care, orthopedics and sports medicine divisions and found variation in the number of opioids prescribed by each doctor. Instead of cutting prescriptions across the board, AAMC physicians worked with their patients to determine the number of opioids actually needed postoperatively by the patient with each specific surgery. AAMCs physicians worked collaboratively to target certain procedures, aiming for a 25% reduction in average MMEs, with an overall 50% reduction in the number of opioid prescriptions by 2019.

  • Is this program operated as part of HSCRC's Care Redesign Amendment?


  • Which Center for Medicare and Medicaid Innovation (CMMI) category does (or would) the program fall under? Choose the best match.


  • What are the major components of the program?

    Patient assessment tools, Patient education/coaching/self-management, Patient care plans, CRISP tools (e.g., Encounter Notification Service)

  • What types of organizations participate in the program?

    Physicians office (primary care), Hospital/health system

  • Which population(s) does the program target?

    Medicare/older adults, Medicaid, Dual eligibles (Medicare-Medicaid enrollees), Privately insured, Individuals with multiple chronic conditions, Frail/disabled, Younger adults, Children

  • How many patients have participated in the program to date?


  • In what Maryland jurisdictions do participating patients reside?

    Anne Arundel, Calvert, Caroline, Charles, Kent, Prince Georges, Queen Annes, Talbot

  • Briefly describe the staffing resources required to operate the program:

    Use existing resources (physicians, PAs, NPs)

  • Briefly describe the key initial steps to implementation:

    Identified targeted procedures for each service line and associated target MME amount; determined through patient feedback, the number of opioids actually needed postoperatively by the patient with each specific surgery; Gained physician buy-in through data presentations

  • Are incentive payments to health care providers part of the program?


  • Which incentive type(s)?

    Shared savings

  • Does the innovation program qualify as a CMS Advanced Alternative Payment Model (APM)?

    Under consideration by Department of Health and Human Services

  • What are/were the expected results in improved outcomes, population health, and cost savings?

    reduction in opioid prescriptions; decrease in unnecessary utilization caused by opioid-related crises

  • Have expected results for improving outcomes and population health been met?

    Results are expected but not yet achieved

  • Please briefly explain your answer to Question 25, and describe any results for improved population health achieved to date:

    Substantially reduced percent of opioid prescriptions (60% decrease in emergency room and orthopedics; 25% decrease in primary care); Difficult to attribute any decrease in opioid-addicted patients to AAMC specifically. Maintained high patient satisfaction scores, Results are expected but not yet achieved

  • Please briefly explain your answer to Question 27, and describe any cost savings results achieved to date:

    Difficult to calculate savings from avoided substance abuse, utilization, etc.