The following is a summary of “Less is More: Fulfillment of Opioid Prescriptions Before and After Implementation of a Modifier 22 Based Quality Incentive for Opioid-Free Vasectomies,” published in the JANUARY 2023 issue of Urology by Nam, et al.

For a study, researchers sought to assess the effect of a payment incentive for opioid-sparing vasectomies on the percentage of patients who filled peri-procedural opioid prescriptions. 

The study used administrative claims data from Blue Cross Blue Shield of Michigan (BCBSM) between February 1, 2018, and November 16, 2020, and included men aged 20-64 who had undergone a vasectomy or a control urologic procedure. Interrupted time series analysis compared the percentage of patients who filled opioid prescriptions before and after July 1, 2019, when BCBSM launched a modifier 22 payment incentive for opioid-sparing vasectomies in Michigan.

The study cohort included 4,559 men who had a vasectomy and 4,679 men who had a control procedure. The results showed that before the implementation of the modifier 22 policy, 32.5% of men who had a vasectomy filled an opioid prescription, while only 12.6% of men filled an opioid prescription after July 1, 2019. This represented a 19.9% absolute reduction and a 61.0% relative reduction (P < .001). In the control group, there was no significant change in the percentage of patients who filled opioid prescriptions before and after July 1, 2019 (0.8% absolute increase, P = .671).

In conclusion, the implementation of the modifier 22 policy was associated with a significant decrease in the percentage of men who filled opioid prescriptions after vasectomy. The finding suggested that payment incentives may be effective in promoting opioid-sparing procedures and reducing opioid use in the perioperative period.

Reference: goldjournal.net/article/S0090-4295(22)00868-8/fulltext