The Centers for Disease Control and Prevention (CDC) on Sept. 15 released a toolkit to help health care payers improve antibiotic use in outpatient settings. The guidance was created through an ongoing partnership between the agency and The Pew Charitable Trusts.
CDC developed the toolkit after a January 2020 meeting convened by Pew that brought together health care stakeholders, including payers, CDC experts, and leaders in antibiotic stewardship. At the meeting, those stakeholders representing payers—the organizations responsible for covering health care costs—spoke of the need for guidance on how to implement antibiotic stewardship strategies to encourage appropriate prescribing and combat the spread of drug-resistant bacteria.
The toolkit identifies activities that health care payers can implement to support antibiotic stewardship efforts throughout outpatient settings, such as primary care clinics and urgent care centers. For example, it outlines different antibiotic use measures that payers can use to assess the prescribing practices of providers in their network.
This resource also includes a sample letter that payers can use to give individual antibiotic prescribing feedback to providers. Tracking and reporting how these drugs are prescribed is a core element of outpatient antibiotic stewardship. These tools help payers identify potential areas for improvement and assess the impact of other activities designed to improve antibiotic use.
Additionally, the toolkit highlights other interventions that payers can implement. For example, they can provide communications trainings to help facilitate conversations between clinicians and patients on antibiotic prescribing decisions. They also can implement patient education campaigns to inform the public on when antibiotics are and aren’t required.
The implementation of outpatient antibiotic stewardship efforts by health care payers is critical to minimizing the threat of antibiotic resistance. That’s because all antibiotic use contributes to resistance, and the majority of antibiotics are prescribed in outpatient settings. There is also significant room for improved prescribing practices, with research showing that 1 in 3 antibiotics prescribed by outpatient providers is unnecessary.
Health care payers are uniquely positioned to promote appropriate antibiotic prescribing in outpatient settings. They also have access to medical and pharmacy claims data, which enables them to pinpoint high rates of prescribing and provide feedback to providers on their prescribing behaviors. Payers also are able to broadly disseminate stewardship resources, such as educational materials, throughout their networks and put in place quality programs focused on improving antibiotic prescribing.
By adopting strategies from CDC’s toolkit, health care payers can help reduce inappropriate antibiotic prescribing, combat the threat of antibiotic resistance, and improve the quality of care delivered to patients.
David Hyun, M.D., leads The Pew Charitable Trusts’ antibiotic resistance project. Rachel Zetts, M.P.H., is an officer and Gaurav Dhiman, M.S., is a senior associate with the project.
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