Reducing Inappropriate Prescribing of Controlled Substances in Medicare Part D: Evidence from a Randomized Intervention

Inappropriate prescribing is a rising threat to the health of Medicare beneficiaries and a drain on the Medicare trust fund.  In this study, we use a randomized controlled trial approach to evaluate a low-cost, light-touch intervention aimed at reducing the inappropriate provision of Schedule II controlled substances in the Medicare Part D program. Potential overprescribers were sent a letter explaining that their practice patterns were highly unlike those of their peers. Using rich administrative data, we fail to detect an effect of these letters on prescribing. We describe ongoing efforts to build on this null result with alternative interventions. Learning about the potential of light-touch interventions will help produce a more nuanced toolkit for policymakers to improve the value and safety of healthcare.