# Stemming the Tide: The Role of Payment and Delivery System Reform in Combating the Opioid Epidemic

> **NIH NIH R01** · DARTMOUTH COLLEGE · 2021 · $596,014

## Abstract

PROJECT SUMMARY
The crisis of opioid misuse, addiction, and overdose has had a devastating impact on communities, with more
than 400,000 people killed from an opioid-related overdose between 1999 and 2017. Because the opioid
epidemic is a complex and heterogeneous issue, effective responses are required from public and private
stakeholders, as well as healthcare systems and communities. The healthcare system has played a partial role
in creating the crisis through liberal use of prescription opioids for pain, and healthcare providers and
organizations have a unique and important role to play in tempering the crisis. By focusing on the dyad of both
opioid prescribing as well as opioid use disorder treatment, healthcare organizations and policymakers may be
able to effectively combat this national epidemic. In order to do so, however, it is necessary to first understand
how various organizational characteristics impact prescribing practices and care for patients with opioid use
disorder across the continuum. In this proposed research, we will use multiple waves of the National Survey of
ACOs and the National Survey of Healthcare Organizations and Systems, linked to national Medicare and
Medicaid claims, as well as American Hospital Association Annual Survey data to assess the role of healthcare
organizations in general, and payment and delivery reforms specifically, on opioid use disorder prevention and
treatment. After fielding another survey wave to create longitudinal responses on opioid related questions, we
will 1) estimate changes in potentially hazardous prescribing, opioid use monitoring, and overdose associated
with organizational characteristics, including alternative payment model participation, and 2) estimate changes
in opioid use disorder treatment associated with organizational characteristics and contractual arrangements.
By combining surveys on organizational response to the opioid crisis with administrative claims data, we will
uncover associations between specific actions by health systems and outcomes that could influence opioid use
disorder and substance use disorders more broadly. As policymakers and providers seek out new methods to
ensure opioids are thoughtfully prescribed and to effectively care for patients with opioid use disorder through
the traditional health care delivery system, our findings will help providers choose the most effective
organizational strategies to combat the opioid epidemic.

## Key facts

- **NIH application ID:** 10215466
- **Project number:** 5R01DA049757-02
- **Recipient organization:** DARTMOUTH COLLEGE
- **Principal Investigator:** Terri D Lewinson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $596,014
- **Award type:** 5
- **Project period:** 2020-07-15 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10215466

## Citation

> US National Institutes of Health, RePORTER application 10215466, Stemming the Tide: The Role of Payment and Delivery System Reform in Combating the Opioid Epidemic (5R01DA049757-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10215466. Licensed CC0.

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