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Potential Strategies for Achieving Our Shared Goals

Posted By Katie Duensing, Wednesday, February 7, 2018

The inaugural Integrative Pain Care Policy Congress was an invitation-only meeting that brought together approximately 70 leaders from 50+ organizations representing the full scope of licensed and certified health care professionals involved in pain care, along with insurers, regulators, people with pain, researchers, and policy experts (see roster). 

The expertise, effort, and resources required to develop effective plans and interventions that address the public health crises of inadequate pain treatment and opioid-related harms are far beyond the capacities of any one organization (see: Why We Came Together), so it is essential that we find ways to work together to develop areas of consensus and strategies for collaboration.

Focusing on meaningful future action for the Congress by working towards consensus policy and advocacy goals for 2018, Congress participants identified many exciting potential strategies for achieving our shared goals. Workgroups based on some of the many ideas below are currently being developed—more on these to come soon!

If you or your organization has a particular interest in any of the below ideas, or if you have other ideas that should be considered, contact Amy Goldstein.

Communication / Advocacy

  • Agree on consensus definition (Done—see definition)
  • Consistent messaging to policymakers, public, etc. (Example—one-pager re: CARA 2.0 with 38 sign-ons and growing!)
  • Decrease competition and confusion between the messages developed between various pain groups represented at the conference by synchronizing our respective messages.
  • Ensure patients are consistently represented on pain initiatives.
  • Develop core set of Talking Points, Position Statements, and other materials to better define the opioid epidemic and required solutions that involve pain (so that conversation not limited to addiction and to decrease competition and confusion among various groups)
  • Ask for a commitment from each organization that we will use common language (the consensus definition at the very least, common talking points if possible)

Data Collection / Measurement

  • Define metrics
  • Keep and mine data
  • Agreement on collection methods
  • Organize trials (e.g., DoD, CMS, payors)
  • Metrics that talk to plans (what are healthcare leaders responsible for and how can we also meet their needs (e.g., HEDIS, NCQA)
    • Identify minimum package of services that might be included in a comprehensive/integrative package
    • Pilots, demonstrations
    • Pitch to Medicare new quality improvement measures related to pain
    • Collaborate with largest purchasers of healthcare plans
    • Identify high risk/complex/ high cost patient populations and allow for bundled payment options and collect outcomes
  • Cultural shift towards measurement-driven care
  • Data that crosses companies
  • Algorithm for how to choose modalities across pain disciplines/services
  • Clinical financial QOL factors
  • Comparative effectiveness studies
  • Create a spectrum of patient centric pathways to address care
  • Identify specifics around coverage challenges and provider network challenges to better understand current system’s failings

Education / Training

  • Large scale education
  • Comprehensive, integrative pain management
  • Earlier treatment / prevention for pain
  • Approach COE, graduate schools for pain education
  • Target pediatric population
  • Get more people with pain engaged in care
  • Networks and support groups for people with pain

Promoting Quality Pain Care / Outcomes

  • Identify exemplar programs
  • Identify suggested/recommended standards for outcome profiles/measurements adopted
  • Health related quality of life
  • Pilot programs (e.g., CMMI, PCORI, model studies)
    • Scale up successful pilots to address scaling concerns in real-life care
  • Identify existing demonstrations for extending kinds of care (e.g., Project ECHO, telepain, U of WA, Healing Place)
  • Recognition of various specialties as part of the team
  • Look to successful models for ideas (e.g., patient-centered medical home, palliative care, oncology care model, integrated behavioral health, collaborative care, interdisciplinary consultation)
  • Explore outcomes for who and what, considering biomarkers
  • Algorithm for choosing modalities across pain disciplines/services
  • Paying for outcomes
  • Demand VA demonstrations report out
  • Need outcomes to develop better coverage (e.g., PROMIS, PASTOR)
  • Monitor for better quality of life, functionality
  • Identify high risk/complex/ high cost patient populations and allow for bundled payment options and collect outcomes
  • Shift focus to developing and implementing pain treatment guidelines vs. opioid treatment guidelines
  • Consensus outcome measures
  • Seek telehealth modalities (when practical) to extend care to rural/underserved areas
  • Quality and outcomes (start with ADLs, lower pain, improve sleep, ER visits, decrease specialist not intervention)
  • Make it easy for frontline providers to implement (critical)

Information Repository

  • Include peer-reviewed information
  • Identify research gaps

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