What is a lock-in program?


According to the white paper, “Healthcare Payer Strategies to Reduce the Harms of Opioids”:

“One strategy that has arisen from drug utilization reviews is the effective use of a lock-in approach to ensure that prescriptions are based on an informed view of the patient. Under a lock-in program, a patient chooses a single provider, a single pharmacy, or both. Payers only impose lock-in after less restrictive steps have been attempted that have been ineffective in curbing “doctor shopping” or the use of multiple, over-lapping prescriptions. Medicaid agencies in forty-eight states and the District of Columbia report having lock-in programs. These programs are intended to improve care coordination between providers and decrease diversion costs.(174) The program design of lock-in programs vary across states with respect to how to determine that patients are “locked-in,” the length of the program, and the restrictions of the program.”


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