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February 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of Healthcare Associated Infections New York State Department of Health

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Page 1: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019

Using Medicaid Data to MapAvoidable Prescribing Practices

Emily Lutterloh, MD, MPHDirector, Bureau of Healthcare Associated InfectionsNew York State Department of Health

Page 2: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019 2

https://www.cdc.gov/antibiotic-use/community/images/programs-measurement/Community-antibiotic-map-2015.jpg

https://www.cdc.gov/antibiotic-use/community/images/programs-measurement/Community-antibiotic-map-2015.jpg

Page 3: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019 3

Analysis• Collaboration with NYSDOH Office of Quality and

Patient Safety– Access to and experience with Medicaid data

• Identify initial visits to outpatient providers for acute upper respiratory infections (URIs)

• Use pharmacy claims data to identify visits when an antibiotic was prescribed and subsequently filled

• Determine regional rates of prescribing for URIs to better target interventions

Based on: Li P, Metlay JP, Marcus SC, Doshi JA. Factors associated with antimicrobial drug usein Medicaid programs. Emerg Infect Dis (Internet). 2014; 20(5): 829-832. https://dx.doi.org/10.3201/eid2005.130493

https://dx.doi.org/10.3201/eid2005.130493

Page 4: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019 4

Analysis• Mapped potentially

avoidable prescribingfor URIs

• Created county-levelmaps based onprovider practicelocation

Page 5: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019 5

Adult Outpatient Antibiotics for Acute URI, 2010 - 2016

Page 6: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019 6

Pediatric Outpatient Antibiotics for Acute URI, 2010 - 2016

Page 7: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019 7

Outreach: Letter to Prescribers• Sent “Dear

Provider” letters and map to providers in 11 high-prescribing counties likely to see patients for URIs

• Followed up with educational materials

Page 8: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019 8

InterventionsAntibiotic Resistance Task Force

Page 9: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019 9

The Future• Next Steps

– Additional years– Other conditions,

e.g. pharyngitis, otitis media

– Overall antibiotic prescribing per Medicaid enrollee

– Assess adherence to guidelines

– Other insurers

• Impact– Target other initiatives– Multiple other initiatives

ongoing simultaneously• Difficult to measure

– Continue to follow as additional yearsof data become available

Page 10: Using Medicaid Data to Map Avoidable Prescribing PracticesFebruary 10, 2019 Using Medicaid Data to Map Avoidable Prescribing Practices Emily Lutterloh, MD, MPH Director, Bureau of

February 10, 2019 10

Thank You

https://www.cdc.gov/antibiotic-use/community/materials-references/print-materials/hcp/index.html

https://www.cdc.gov/antibiotic-use/community/materials-references/print-materials/hcp/index.html

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