# Implementation, Outcomes, and Cost of a Novel Medicaid Policy to Reduce Opioids for Back Pain

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2021 · $8,932

## Abstract

Project Summary
To address opioid misuse and related morbidity and mortality, Oregon has initiated a novel statewide effort to
use Medicaid benefit design to promote safer opioid prescribing practices around back pain. Under the new
policy, Oregon Medicaid will sharply curb coverage of opioid medications for acute back pain and require
physicians to develop a plan with patients on chronic opioid therapy for back pain to taper off this therapy by
early 2018. Concurrently, Oregon Medicaid has expanded coverage of nonpharmacologic health services for
back pain, including acupuncture, chiropractic manipulation, cognitive behavioral therapy, physical and
occupational therapy, yoga, massage and supervised exercise therapy.
This policy is the first of its kind in the country, and if successful, could serve as a model for other states in
minimizing the potential harms of long-term opioid therapies while providing other evidence-based options to
relieve pain. We will examine the clinical and economic effects of the policy, using Utah Medicaid enrollees
with back pain and Oregon and Utah Medicaid enrollees without back pain as comparison groups, allowing us
to isolate the effect of the policy.
The study has three specific aims: First, we will evaluate the impact of the OBPP on opioid and non-opioid
prescribing and use of non-pharmacologic therapies. Second, we will evaluate the impact of the policy on a)
opioid-related clinical outcomes (e.g., overdose) or development of opioid use disorders b) back pain related
clinical outcomes, as indicated by advanced imaging and/or need for surgery and c) overall healthcare service
utilization and total health care spending for back-pain or opioid-related health care visits, prescription drugs,
and non-pharmacologic services. Finally, we will conduct stakeholder interviews and focus groups with
administrators and clinicians to characterize implementation approaches, barriers, and perceived effectiveness
of the policy.
Study findings will inform policymakers, health administrators, and practitioners nationwide on the
effectiveness of large-scale implementation of benefit design policy to increase use of evidence-based
practices and reduce opioid-related harms.

## Key facts

- **NIH application ID:** 10398651
- **Project number:** 3R01DA044284-04S1
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Esther K Choo
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $8,932
- **Award type:** 3
- **Project period:** 2018-08-15 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10398651

## Citation

> US National Institutes of Health, RePORTER application 10398651, Implementation, Outcomes, and Cost of a Novel Medicaid Policy to Reduce Opioids for Back Pain (3R01DA044284-04S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10398651. Licensed CC0.

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