title: Medicare Letters To Curb Overprescribing Of Controlled Substances Had No Detectable Effect On Providers.
abstract: Inappropriate prescribing is a rising threat to the health of Medicare beneficiaries and a drain on Medicare's finances. In this study we used a randomized controlled trial approach to evaluate a low-cost, light-touch intervention aimed at reducing the inappropriate provision of Schedule II controlled substances in the Medicare Part D program. Potential overprescribers were sent a letter explaining that their practice patterns were highly unlike those of their peers. Using rich administrative data, we were unable to detect an effect of these letters on prescribing. We describe ongoing efforts to build on this null result with alternative interventions. Learning about the potential of light-touch interventions, both effective and ineffective, will help produce a better toolkit for policy makers to improve the value and safety of health care.
authors.affiliation: Adam Sacarny (ajs2102@columbia.edu) is an assistant professor in the Department of Health Policy and Management at the Mailman School of Public Health, Columbia University, in New York City.
authors.forename: Adam
authors.initials: A
authors.lastname: Sacarny
authors.affiliation: David Yokum is a fellow at the White House Social and Behavioral Sciences Team and director of the Office of Evaluation Sciences in the General Services Administration, both in Washington, D.C.
authors.forename: David
authors.initials: D
authors.lastname: Yokum
authors.affiliation: Amy Finkelstein is the Ford Professor of Economics in the Department of Economics at the Massachusetts Institute of Technology; co-scientific director of J-PAL North America; and codirector of the Public Economics Program at the National Bureau of Economic Research, all in Cambridge, Massachusetts.
authors.forename: Amy
authors.initials: A
authors.lastname: Finkelstein
authors.affiliation: Shantanu Agrawal is deputy administrator and director of the Center for Program Integrity at the Centers for Medicare and Medicaid Services, in Baltimore, Maryland.
authors.forename: Shantanu
authors.initials: S
authors.lastname: Agrawal
mesh_terms: D061891:Controlled Substances / Q000191:economics*; D015709:Correspondence as Topic; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D006282:Health Personnel / Q000191:economics; D006801:Humans; D057970:Inappropriate Prescribing / Q000191:economics / Q000517:prevention & control*; D008297:Male; D054524:Medicare Part D / Q000191:economics* / Q000706:statistics & numerical data; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D014481:United States
chemical_list: D061891:Controlled Substances
keywords: Financing Health Care; Medicare; Mental Health/Substance Abuse; Pharmaceuticals; Physicians