https://www.fairhealth.org/states-by-the-numbers/map

FAIR Health is an independent nonprofit that collects data and maintains the country’s largest database of privately billed health insurance claims. They released a new white paper on opioid abuse and dependence, specifically when it comes to regional and state difference in treatment.

They analyzed the top 10 procedure codes associated with opioid abuse and dependence diagnosis by utilization and aggregate cost in four regions (Northeast, Midwest, South, West), and five types of codes by state (behavioral health, medication-assisted treatment, inpatient treatment, outpatient rehabilitative services, emergency department visits).

They found wide variation, and issued a coordinating “heat map” to show which areas have higher opioid abuse and dependence claim lines as a percentage of total medical claim lines in 2017. Users can further drill down by state to see infographics including the top five procedure codes by utilization and aggregate cost, and diagnoses by age and gender. West Virginia, California, Kentucky, Florida and Rhode Island were among the states where the percentage was highest.

Group psychotherapy and methadone administration were common country-wide, but methadone administration was more common in the Northeast was naltrexone injection was more common in the Midwest. Outpatient rehabilitative services were linked to the South and the West more so than other regions. The South relied on more testing rather than therapeutic procedures. The West emphasized treatment, two inpatient treatments (sub-acute detoxification and short-term residential) were in the West’s top 10 procedures by cost. Emergency department visits were in the top 10 list by cost in the Northeast and Midwest.

Amongst the states, New York was the only one with group counseling as one of its five most common procedures by utilization and cost. Only California had intensive outpatient treatment in its top five list by utilization. Sub-acute detoxification was only in the top five list by cost for Mississippi and Tennessee. Wyoming was the only state who had emergency department visit, high severity, immediate significant threat to life or physiologic function among its top five procedures by cost.

These differences may offer opportunities to look at what outcomes come with varying treatment strategies.

FAIR Health has released three previous white papers on the opioid epidemic. The first looks at national trends, the second looks at the impact of the epidemic on the healthcare system and the third looks at geographic variations.

Read the full white paper here.