Michigan Health Care Group Whose Members Cover Seven Million State Residents Creates Common Guidelines for Opioid Prescribing

Brianna Neace

| 3 min read

Pill bottle
DETROIT, Dec. 15, 2017 – An organization whose members include health plans that cover more than seven million Michigan residents--as well as leading physician groups in the state -- today announced they are supporting a set of key guidelines for prescribing opioids for pain management. The Michigan Quality Improvement Consortium (MQIC—pronounced “M-quick”), created the opioid prescribing guidelines and are distributing them to more than 12,000 primary care and specialty physicians across the state. MQIC’s work is one of the largest efforts in the country to consolidate common one-page treatment guidelines or protocols and simultaneously to agree upon a standard way to measure whether patients receive treatment according to the guideline. The group previously created one-page treatment guidelines for other major health conditions, including diabetes, hypertension and asthma. “Opioid abuse is an issue that touches all of us. We hope by supporting recommended prescribing guidelines across the board, the health care community can help address this growing problem,” said Thomas Simmer, M.D., senior vice president and chief medical officer for Blue Cross Blue Shield of Michigan, and co-chair of MQIC. Participating in MQIC and supporting the guidelines are Aetna Better Health of Michigan, Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan, Blue Cross Complete of Michigan, HAP Midwest Health Plan, Harbor Health Plan, Health Alliance Plan, Meridian Health Plan, Michigan Association of Health Plans, Michigan Department of Health and Human Services, Michigan Osteopathic Association, Michigan State Medical Society, Molina Health Care, Inc., MPRO, Physicians Health Plan, Priority Health, Total Health Care Inc., UnitedHealthcare Community Plan and University of Michigan Health System. The guidelines say initial treatment for chronic or acute pain should avoid opioids by prescribing non-opioid medications and non-drug therapy such as physical or behavioral therapy. The recommendations ask physicians to assess the risk of opioid dependence in each patient before prescribing opioids. The guidelines advise there is no safe lower limit of dose or duration for opioid use. When starting a prescription, the recommendation is to prescribe the lowest effective dose and smallest quantity—and cites three days or fewer for acute pain. Based on guidelines issued by the Centers for Disease Control, the MQIC guidelines say physicians should discuss realistic goals with patients for pain management and ability to function, and how opioid therapy will be discontinued if benefits do not outweigh potential harm. If continuing with opioids, the guidelines ask physicians to periodically re-evaluate pain and function, and to consider an opioid treatment agreement. It advises drug screening if concerned about substance abuse or possible diversion of drugs for sale. “Common guidelines and performance measurement achieve better acceptance and support by physicians, reduce confusion, and enable focus on the most important practice issues,” said Simmer. “This contributes to more consistent and safer care, wider adoption of best practices, and better health outcomes for patients.” MQIC establishes a common performance measurement strategy among all participating health plans. This simplifies administration for physicians, who previously had to use multiple and sometimes overlapping guidelines from health plans and other groups. “We hope these guidelines help ensure that patients in pain are treated safely and effectively while minimizing the risk of harm to themselves, their families, or their communities from opioids,” said John E. Billi, M.D. Billi is also co-chair of MQIC, medical director of Collaborative Quality Initiatives, and professor of internal medicine and learning health sciences at the University of Michigan Medical School. Information about opioid and other MQIC guidelines are available on **This release was distributed by The Michigan Quality Improvement Consortium (MQIC) of which Blue Cross Blue Shield of Michigan and Blue Care Network are members.
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