FAIR Health Releases Interactive Tool Tracking Opioid Abuse and Dependence State by State

October 17, 2024

In September, FAIR Health released the Opioid Tracker, a free, interactive tool tracking opioid abuse and dependence state by state. A brief released simultaneously offers a user’s guide to the Opioid Tracker.

Available on FAIR Health’s website fairhealth.org, the Opioid Tracker includes a heat map representing the percentage of patients with opioid abuse and dependence diagnoses compared to all patients receiving medical services in 2023 for each state. Clicking on a state displays an infographic for that state. The infographic includes the top five procedure codes by utilization for opioid abuse and dependence, the top five procedure codes by aggregate allowed amounts for opioid abuse and dependence,¹ the change in the percentage of patients with opioid abuse and dependence diagnoses compared to all patients receiving medical services from 2020 to 2023, and the distribution of patients with opioid abuse and dependence diagnoses by age and gender. There is also a similar infographic for the nation as a whole. The source of the data is FAIR Health’s repository of commercial healthcare claims, now at over 48 billion claim records, the largest such repository in the nation.

Among the key findings revealed by the Opioid Tracker:

• Nationally, the percentage of patients with opioid abuse and dependence diagnoses compared to all patients receiving medical services from 2020 to 2023 showed an overall increase. In 2020, patients with opioid abuse and dependence diagnoses accounted for 0.412 percent of all patients receiving medical services, while in 2023 they accounted for 0.442 percent, an increase of 7.3 percent.
• In 2023, procedure code H0020 (methadone administration and/or service) was the most commonly used code for opioid abuse and dependence, representing 20.6 percent of claim lines for all procedure codes for opioid abuse and dependence nationally.
• In terms of overall cost, H0018 (behavioral health short-term residential treatment program, no room and board, per diem) accounted for 11.9 percent of aggregate allowed amounts for opioid abuse and dependence in 2023, more than any other individual code.
• Nationally, 27.3 percent of opioid abuse and dependence diagnoses were attributable to patients in the 51 to 65 age group in 2023, more than any other age group.
• Males were 56.9 percent of patients with opioid abuse and dependence diagnoses in 2023, while females were 43.1 percent.

FAIR Health President Robin Gelburd stated: “The Opioid Tracker sheds light on multiple aspects of opioid abuse and dependence, including utilization, costs, age and gender. We hope that the Opioid Tracker will be useful to all healthcare stakeholders, such as policy makers, payors, providers, patients and researchers, as they continue to track and seek to better understand and address this public health issue.”

For the Opioid Tracker, click here. For the user’s guide to the Opioid Tracker, click here.

^{1 An allowed amount is the total negotiated, in-network fee paid to the provider under an insurance plan. It includes the amount that the health plan pays and the part the patient pays under the plan’s in-network cost-sharing provisions (e.g., copay or coinsurance if the patient has met the deductible). The aggregate allowed amount for a given procedure is simply the sum of all the allowed amounts for that procedure in the applicable geographic area during the time frame.}