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

Nationally, in 2022, Patients Aged 31-40 Ranked Highest among Age Groups for Percentage of Claim Lines for Opioid Abuse and Dependence

NEW YORK, NY—September 28, 2023—Today FAIR Health launched 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 opioid abuse and dependence claim lines as a percentage of all medical claim lines in 2022 state by state.¹ 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,² the change in opioid abuse and dependence claim lines as a percentage of all medical claim lines from 2018 to 2022, and diagnoses of opioid abuse and dependence 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 over 42 billion private healthcare claim records, the largest such repository in the nation.

Among the key findings revealed by the Opioid Tracker:

In 2022, H0020 (methadone administration and/or service) had the highest utilization nationally of all procedure codes for opioid abuse and dependence, representing 21.6 percent of claim lines for all such procedure codes.
Ranking in first place by total spending nationally for opioid abuse and dependence, H0018 (behavioral health short-term residential treatment program, no room and board, per diem) accounted for 9.8 percent of aggregate allowed amounts attributable to procedure codes for opioid abuse and dependence in 2022.
Nationally, the percentage of medical claim lines for opioid abuse and dependence from 2018 to 2022 showed an overall decline, from 0.254 percent in 2018 to 0.196 percent in 2022. However, a number of states showed an increase in that percentage—including Arizona, Georgia, Indiana and Rhode Island, among others.
Nationally, in 2022, patients aged 31 to 40 were the age group with the highest percentage of opioid abuse and dependence claim lines, 31.1 percent.
Nationally, in 2022, males accounted for 62.5 percent of claim lines with opioid abuse and dependence diagnoses, while females accounted for 37.5 percent.

The Opioid Tracker is the latest addition to FAIR Health’s series of trackers offering geographic windows into healthcare data. The series also includes the Monthly Telehealth Regional Tracker, which tracks telehealth utilization by region across the nation; and the Cost of Giving Birth Tracker, which shows state-specific and national median costs for vaginal deliveries and C-sections.

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 A claim line is an individual service or procedure listed on an insurance claim.

² 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).

About FAIR Health

FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation’s largest collection of commercial healthcare claims data, which includes over 49 billion claim records and is growing at a rate of over 3 billion claim records a year. FAIR Health licenses its commercial data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D, which accounts for a separate collection of over 49 billion claim records; FAIR Health includes among the commercial claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health’s systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 Type 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers’ compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish, which enables consumers to estimate and plan for their healthcare expenditures and offers a rich educational platform on health insurance. An English/Spanish mobile app offers the same educational platform in a concise format and links to the cost estimation tools. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger’s Personal Finance. For more information on FAIR Health, visit fairhealth.org.

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

Nationally, in 2022, Patients Aged 31-40 Ranked Highest among Age Groups for Percentage of Claim Lines for Opioid Abuse and Dependence

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