In 2014, Indiana’s opioid prescribing rate for Medicare enrollees ranked 14th highest in the U.S., and 15% of all drugs prescribed were opioids. Clinton County’s average rate of non-fatal emergency department visits due to overdose was 79 per 100,000 – that was two times higher than the state rate. Qsource was selected to address this issue in Clinton County, Indiana through a Special Interest Project (SIP) awarded by the Centers for Medicare and Medicaid (CMS). I was the Marketing and Communications Project Lead for the SIP.

Qsource staff worked to identify frequent visitors to the emergency department in the county's hospital system, particularly ones with opioid requests. The first tactic for the project was to send a letter to those identified patients with alternative resources for pain management. 

The team recruited all of the Medicare Part D prescribers in the county and gave them a toolkit developed by the Indiana Drug Prevention Task Force. The toolkit contained resources for the prevention and treatment of opioid misuse, as well as non-opioid intervention resources. 

Partnering with a local nonprofit, Healthy Communities of Clinton County, the Qsource team worked to raise awareness and increase educational opportunities around opioid misuse through billboards, social media, health fairs, and more. 

1) Decrease emergency department visits by 40%, which translates to 863 fewer visits 

2) 25% decrease in inappropriate prescribing resulting in a reduction of 1,160 opioid claims

3) 25% decrease in opioid related admissions/readmissions translating to 315 fewer hospitalizations

Working with our graphic designer/webmaster, we developed a website for the campaign. The goal was to have one central place for all of the campaign materials to be accessible to both prescribers and patients. We chose to use a shade of green from our brand colors on the website and throughout the campaign for consistency and cohesion. 

The website was active throughout the campaign and was visited more than 16,000 times.

I designed the billboards using Photoshop and crafted the messages with input from our team in Indiana. The billboards directed viewers to visit the website and/or call our partner, Healthy Communities of Clinton County, for opioid education. 

The strategically placed billboards were estimated to have been viewed 269,715 times.

I created and purchased targeted advertising on Facebook to reach the Clinton County community and compliment our billboards and other tactics. 

The three-month ad campaign on Facebook cost approximately $300. The ads were viewed 49,000 times by 11,516 individuals. 

With input from our on-staff pharmacist, I created these prescription pads to assist providers in reducing opioid prescriptions. Qsource had them printed and shipped to all participating Medicare Part D prescribers in Clinton County. 

We created some original educational materials to share in the county at events and make available on the website. I edited and approved the content of the materials and ensured all branding standards were met.

In order to extend the progress we made, my team created a Project Guide with accompanying videos. This document described our tactics and resources so the success could be duplicated in the future. I wrote the scripts for the videos and worked with our graphic designer to bring them to life. 

In the first year of the project, 723 fewer opioid prescriptions were written by emergency department physicians. As of January, 2019, an 83.2% reduction in prescribing of opioids in the emergency department had been achieved for this Indiana community. This greatly reduced the number of opioid tablets available for misuse or diversion.

87% of our recruited prescribers implemented at least one intervention. As of 2018 Q3, we helped reduce Medicare enrollee opioid prescribing rates for:

- emergency department prescribers from 18% to 12%;

- dentists from 19% to 16%; and

- community-based prescribers from 3.4% to 1.64%.

Estimated total savings was approximately $1,079,845 and contract funding was $477,208, giving us an estimated ROI of $2.26 per $1.00 spent. The ROI calculation did not include additional cost avoidance related to decreased opioid prescribing, such as fewer hospitalizations and decreased opioid-related complications of chronic disease or surgery.