Meeting HEDIS POD Requirements
How Digital Recovery Support Can Help Extend OUD Medication Adherence
August 10, 2026
Starting medication for opioid use disorder is an important step toward recovery, but the larger challenge is staying on it. National data consistently show that most people who begin buprenorphine treatment for opioid use disorder (OUD) stop long before they reach six months, the point at which pharmacotherapy has been shown to reduce overdose risk and support sustained recovery. This drop-off has real consequences in lives and dollars, which is why the National Committee for Quality Assurance (NCQA) developed the Pharmacotherapy for Opioid Use Disorder (POD) measure to track whether treatment lasts.
A Measure Built Around the Hardest Part of Recovery
The POD measure tracks the percentage of new OUD pharmacotherapy events that last at least 180 days among individuals aged 16 and older with a diagnosed opioid use disorder. A “treatment period” begins on the date a person starts an FDA-approved OUD medication, such as buprenorphine or naltrexone, and runs through day 179, with no gap in treatment of eight or more consecutive days along the way.
NCQA’s 180-day time period aligns with the minimum treatment duration that the Centers for Medicare and Medicaid Services and the National Quality Forum have identified as necessary for pharmacotherapy to improve outcomes. The problem is that this is when treatment is most likely to fall apart. Research published in the Journal of Substance Abuse Treatment found that among Medicaid enrollees starting buprenorphine, more than 25% stopped within the first month, and nearly 65% quit before reaching the 180-day mark. A more recent nationwide claims analysis put retention even lower, finding that 71% of buprenorphine episodes were discontinued by day 180, leaving a retention rate of just 29%.
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Those numbers matter because OUD carries such steep risks and costs. People with OUD face increased chances of fatal overdose, emergency department visits, hospital readmission, and blood-borne infections. Overdose deaths involving opioids were on the rise for years before recent modest declines. Still, the cost of substance misuse and substance use disorders in the U.S., including lost productivity, health care spending, and crime-related costs, exceeds $400 billion annually.
Early Days of OUD Treatment Present Risks
Research on individuals who walk away from OUD pharmacotherapy treatment reveals a consistent pattern. The risk of dropping out is highest in the earliest weeks, when withdrawal symptoms, cravings, transportation barriers, and life stressors are high, and taking the medication has not yet become part of a person’s routine. A variety of factors, like lower initial dosing, younger age, co-occurring substance use, a recent overdose, and any inpatient care in the months before starting treatment, are linked to early discontinuation. This population needs more contact and support at this stage, not less.
Impact on Health Plans and Providers
For health plans, POD performance is a direct line item in quality reporting and indicates how well members are supported during one of the riskiest phases of treatment. A plan with low POD rates is very likely also covering the costs of relapse, repeat detox admissions, emergency department visits, and overdoses among members who started and quit treatment.
For providers and treatment programs, early discontinuation represents lost continuity of care. Each person who drops out of treatment early represents a missed clinical opportunity and real revenue impact, particularly for programs that depend on sustained engagement to justify staffing and capacity for Medications for Opioid Use Disorder (MOUD) services.
The Cost of Treatment That Doesn’t Last
Individuals who use pharmacotherapy for just a short period are likely to return to use, be at risk for overdose, and increase their reliance on crisis-level care. Because OUD pharmacotherapy is one of the most effective interventions available for reducing opioid-related fatal overdose, every early discontinuation represents a missed opportunity to prevent death.
The financial challenges quickly add up. Members who cycle in and out of treatment generate repeated costs across detox, inpatient, and emergency care rather than the less expensive, predictable cost of longer-term outpatient pharmacotherapy. For plans and providers trying to manage both patient outcomes and cost of care, keeping people in treatment past the 180-day threshold is one of the highest-impact interventions available.
Bridging the Gap With Integrated Digital Support
Medication is necessary, but on its own, it isn’t enough to hold someone through six months of treatment. The factors that lead individuals to quit —fading motivation, isolation, unaddressed stressors — tend to occur between appointments, in the ordinary days when no one is checking in. CHESS Health’s eRecovery platform is built to close those gaps.
Our customizable Rewards Engine automates contingency management, one of the most extensively studied and effective tools for reinforcing ongoing treatment engagement. CHESS Health works directly with clients to tailor the platform to their population: which behaviors earn rewards, how and when those rewards are delivered, and what notifications participants receive to stay engaged with their treatment plan. Every interaction is captured in a comprehensive audit trail, providing clients with the outcome reporting they need to demonstrate measurable progress toward POD and related quality targets.
Alongside the Rewards Engine, our Connections app keeps individuals engaged in recovery well beyond the clinic walls. A 24/7 peer-engagement team, daily check-ins, virtual support meetings, and crisis intervention give members continuous support precisely during the early weeks and months when treatment is most likely to break down. Together, these tools give health plans a way to extend clinical care into the everyday moments where treatment engagement is actually won or lost.
Retention is a Revenue Strategy
Research reveals two opposing outcomes: medication for opioid use disorder saves lives when people stay on it, and, unfortunately, most people don’t stay on it long enough to achieve results.
Digital recovery support that combines contingency management with 24/7 peer engagement addresses the measure’s intent directly by keeping members connected, engaged, motivated, and accounted for through the months when they need encouragement the most. For health plans working to improve POD performance, this continuous, always-on support turns one of the most vulnerable periods in recovery into one of the strongest opportunities to demonstrate quality, protect members, and reduce the long-term cost of untreated opioid use disorder.
