Upstate New York Surgeons Work With Excellus BlueCross BlueShield to Establish Post-Surgery Opiate Prescription Guidelines That Reduce Number of Unused Pills

​​Surgeons from 18 upstate New York hospitals and health centers are collaborating with each other and with Excellus BlueCross BlueShield to reduce the number of unnecessary opioid pills prescribed when patients are discharged from the hospital following any of 21 different surgical procedures. 

The goal is to lower the risk of opioid misuse by reducing the number of opiate medications prescribed through a collaborative approach that blends the experience of surgeons and their hospitals with the data analytics of Excellus BCBS. The guidelines established by the surgeons themselves will help to ensure that patients can adequately control their pain in the postoperative period.

“We’re honored to play a convening role with our surgeon partners to help them identify best practices, establish prescribing guidelines and periodically review data we collect for them so they can analyze and share their experiences with one another,” said LouAnne Giangreco, M.D., vice president and chief medical officer for health care improvement at Excellus BCBS. “This approach helps us achieve our mission, which is to collaborate with doctors to improve care for our members and our communities.”

The surgical quality initiative on opioid prescriptions began in 2018 when surgeons and nurses from 17 hospitals got together with the health plan to address the problems of opioid dependency and abuse.

The surgeons reviewed best practices and reached a consensus on appropriate opioid levels to prescribe for patients who have undergone any of 21 different procedures, which range from more intensive total knee replacement surgery to incision-less surgery for bladder tumors.

“The idea was for the surgeons and Excellus BCBS to develop some baseline data on those surgeries, and for the surgeons to set goals that move discharge prescriptions to the agreed-upon best practice levels over time,” said Giangreco. This month marks the beginning of the new measurement period when the health care providers will be able to analyze, compare and demonstrate improvement.

 

Participating hospitals with surgeon champions in the program include:

 

Finger Lakes Region

  • Clifton Springs Hospital
  • Highland Hospital
  • Newark-Wayne Community Hospital
  • Rochester General Hospital
  • Strong Memorial Hospital
  • Unity Hospital​ 

Central New York Region

  • Oswego Hospital
  • St. Joseph’s Health Hospital
  • SUNY Upstate Medical University (2 sites)

Southern Tier Region

  • Our Lady of Lourdes Memorial Hospital
  • United Health Services Hospitals (1 site)​ 

Utica/Rome/North Country Region

  • Bassett Medical Center
  • Samaritan Medical Center
  • A.O. Fox Hospital
  • St. Elizabeth Medical Center

Western New York Region

  • Kaleida Health (2 sites)
  • Erie County Medical Center (ECMC)
  • United Memorial Medical Center (Batavia)

Surgeries included in the program:

  • Total knee replacement                          
  • Lumbar laminectomy                             
  • Total hip replacement                            
  • Cervical arthroplasty/discectomy/fusion     
  • Lumbar microdiscectomy                        
  • Rotator cuff repair                                 
  • Panniculectomy                                    
  • Total abdominal hysterectomy                 
  • Breast reduction                                   
  • Laparoscopic cholecystectomy                 
  • Laparoscopic vaginal hysterectomy           
  • Inguinal hernia repair                             
  • Laparoscopic nephrectomy                     
  • Laparoscopic gastric bypass                    
  • Laparoscopic gastric sleeve                     
  • Carotid endarterectomy                         
  • Mitral valve replacement                        
  • VNUS closure  (varicose vein treatment)                                 
  • Transurethral Resection of the Bladder Tumor (TURBT)                                          
  • Endoscopic sinus surgery                        
  • Coronary Artery Bypass Grafting (CABG)                                                              

Excellus BlueCross BlueShield, an independent licensee of the Blue Cross Blue Shield Association, is a nonprofit health plan with 1.5 million upstate New York members. The company's mission is to help people live healthier and more secure lives through access to high-quality, affordable health care. Its products and services include cost-saving prescription drug discounts, wellness tracking tools and access to telemedicine. With more than 3,500 employees, the company is committed to attracting and retaining a diverse workforce to foster innovation and better serve its members. It also encourages employees to engage in their communities by providing paid volunteer time off as one of many benefits. To learn more, visit ExcellusBCBS.com.

Source: Excellus BlueCross BlueShield

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