NEW YORK, PRNewswire
Nationally, among the commercially insured population, patients with opioid use disorder diagnoses showed an overall increase from 2021 to 2024, according to FAIR Health’s Opioid Tracker. In 2021, there were 386 patients with opioid use disorder diagnoses per 100,000 patients, while in 2024 there were 539, an increase of 39.8 percent. This and other findings were reported today when FAIR Health released its annual update of the Opioid Tracker, a free, interactive tool tracking opioid use disorder among commercially insured patients nationally and state by state.
A brief released simultaneously offers a user’s guide to the Opioid Tracker.
The Opioid Tracker includes a heat map representing patients with opioid use disorder diagnoses per 100,000 patients receiving medical services in 2024 for each state. Clicking on a state displays an infographic for that state with opioid use disorder data from 2024. The infographic includes the top five procedure code categories by utilization, the top five procedure codes by aggregate allowed amounts,1 the change in the number of patients with opioid use disorder diagnoses per 100,000 patients from 2021 to 2024, and the distribution of patients by age and gender. There is also a similar infographic for the nation as a whole, along with a second national infographic showing the top five states for opioid use disorder diagnoses, the fastest-growing specialties, the distribution of places of service, and service type (professional versus facility) as a percentage of total allowed amounts. The source of the data is FAIR Health’s repository of commercial health claims.
Among the key findings revealed by the Opioid Tracker:
- In 2024, Tennessee had the highest rate of commercially insured patients receiving treatment for opioid use disorder, with 1,447 patients with such a diagnosis per 100,000 patients. It was followed by West Virginia (1,323 patients), Kentucky (1,281 patients), Arkansas (1,218 patients) and Delaware (1,165 patients).
- Nationally in 2024, alcohol/substance abuse services and treatments constituted the procedure code category with the highest utilization for opioid use disorder among commercially insured patients, representing 39.5 percent of claim lines2 for all procedure code categories for that diagnosis.
- Nationally in 2024, H0018 (behavioral health short-term residential treatment program, no room and board, per diem) was the procedure code with the highest aggregate allowed amount for opioid use disorder among commercially insured patients, accounting for 12.7 percent of aggregate allowed amounts for that diagnosis. The average allowed amount for this code was $1,124.
- The highest percentage of opioid use disorder diagnoses among commercially insured patients were attributable to patients in the 31 to 40 age group, with 26.8 percent of the total age distribution in 2024 across the nation.
- Among commercially insured patients with opioid use disorder diagnoses nationally in 2024, males were 55.7 percent of patients with those diagnoses, while females were 44.3 percent.
- The fastest-growing specialty involved in the treatment of opioid use disorder nationally in 2024 was nurse practitioner, which increased 102 percent in percent of claim lines from 2021 to 2024. In second and third position, respectively, were physician assistant (69 percent) and psychiatric nurse (66 percent).
| 1 | An allowed amount is the total negotiated, in-network fee paid to the provider under an insurance plan. It includes the amount that the health plan pays and the part the patient pays under the plan’s in-network cost-sharing provisions (e.g., copay or coinsurance if the patient has met the deductible). The aggregate allowed amount for a given procedure is simply the sum of all the allowed amounts for that procedure in the applicable geographic area during the time frame. | |||||
| 2 | A claim line is an individual service or procedure listed on an insurance claim. | |||||
For the Opioid Tracker, click here. For the user’s guide to the Opioid Tracker, click here.
The Views Expressed In This Article Belong Solely To The Original Author, And We Assume No Responsibility For Its Accuracy, Completeness, Or Any Consequences Arising From Its Use.
