• Liliana Tenney, Lisa M McKenzie, Brenden Matus, Kathryn Mueller, and Lee S Newman.
• Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.
• Am. J. Ind. Med. 2019 Jan 1; 62 (1): 21-29.

ObjectiveThe aim of this study was to examine adherence of state guidelines for Colorado workers' compensation physicians/providers treating individuals as injured workers with chronic pain after initiation of an opioid management program and provider incentives.MethodsA retrospective cohort of chronic, non-cancer pain claims was constructed from the Colorado's workers' compensation database. Adherence to treatment guidelines and opioid prescribing practices were evaluated during implementation of a new billing code to incentivize adherence.ResultsOverall, less than 33% of claims showed evidence of opioid management. Comprehensive opioid management was observed in only 4.4% of claims. In 2010, after implementing the new billing code, the ratio of long acting opioids to short acting opioids decreased from 0.2 to 0.13; returning to 0.2 in one year. Similarly, morphine equivalent doses declined for a short period.ConclusionsIncentivizing physicians to adhere to chronic pain management guidelines only temporarily improves prescribing practices.© 2018 Wiley Periodicals, Inc.

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