Concurrent Use of Opioids and Benzodiazepines

Identifying Attributes

Care Settings
Primary Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Medicare Advantage (Part C) and Part D Star Ratings
Type of Quality Indicator
Process
IOM Quality Dimension
Safety
Domain
Medications and Medication Management

Defining Attributes

Definition

This measure evaluates the proportion of people concurrently using prescription opioids and benzodiazepines.

Numerator

The number of member-years of beneficiaries in the denominator with at least 2 prescription claims of a benzodiazepine with unique dates of service and concurrent use of opioids and benzodiazepines during the measurement period.

Denominator

The number of member-years of enrolled beneficiaries, 18 years or older, with at least 2 prescription claims of a prescription opioid with unique dates of service and at least 15 cumulative days supply of opioids during the measurement period.

Exclusions

Contracts with 30 or fewer enrolled member-years (in the denominator), beneficiaries enrolled in hospice, with a cancer diagnosis, with a sickle cell disease diagnosis or receiving palliative care during the measurement year were excluded.

Use of Risk Adjustment
No
Risk Adjustments
Stratifications

Collection and Reporting Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Prescription Drug Event (PDE) data files submitted to CMS Drug Data Processing System (DDPS), Common Medicare Environment (CME) for enrolment information, the Minimum Data Set (MDS) for nursing home information, the Common Working File (CWF) ICD-10-CM codes to identify diagnoses, the Encounter Data Systems (EDS) used to identify diagnoses based on ICD-10-CM codes, and the PQA Medication Lists, which include the NDCs for this measure.

Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
Reporting Methods
Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
Yes
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
02 December 2025