Federal Policymakers Look to Integrative Pain Care to Reduce Opioid Use
Tuesday, January 23, 2018
Posted by: Katie Duensing, J.D.
If the early days of 2018 are any indication, this year may be the turning point for integrative pain management that advocates in the field have all been working toward. Within the past few weeks and months, there have been numerous exciting developments at the federal level that have the potential to greatly expand access to high quality, evidence-informed, and affordable comprehensive integrative pain management.
CMS has announced a new payment model to improve quality, coordination, and cost-effectiveness for both inpatient and outpatient care. The voluntary bundled payment model is called Bundled Payments for Care Improvement Advanced (BCPI Advanced). Participants may receive payments for 32 different clinical episodes, such as major joint replacement of the lower extremity (inpatient) and percutaneous coronary intervention (inpatient or outpatient). This program will run from October 1, 2018 through December 31, 2023, and applications to participate must be submitted by March 12, 2018. Read more
The Institute for Clinical and Economic Review (ICER) released a Final Evidence Report recommending enhanced coverage of certain non-drug management options for chronic low back pain. The report assesses the comparative clinical effectiveness of acupuncture, cognitive behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), tai chi, and yoga for treatment of chronic low back and neck pain, as well as the value of these therapies in chronic low back pain. Read ICER’s Chronic Low Back and Neck Pain: Final Report.
Sen. Schatz (D-HI) introduced S. 2260, The Opioids and STOP Pain Initiative Act of 2017 on December 21st. The bill appropriates $5 billion over five years for new NIH-directed research. The initiative aims to spur research into novel drugs and non-pharmacological treatments for pain; directs NIH to intensify and coordinate fundamental, translational, and clinical research related to pain; will establish a Pain Therapeutics Screening Program; and much more. More information will be coming soon around collective action for this bill.
FDA has released its 2018 Strategic Policy Roadmap. There are a number of strategies, including modifications to REMS programs that require, for example: training on non-opioid pain alternatives; training for prescribing related to immediate-release formulations of opioid drugs; and, broader training that covers more health care providers who help manage patients with pain. Additionally, there is a plan to leverage nutrition and diet as ways to reduce morbidity and mortality from disease; we have identified dietary factors as one contributor to patients’ pain experience.
Read the 2018 Strategic Policy Roadmap
The Agency for Healthcare Research and Quality’s (AHRQ’s) request for comments related to its Review of Noninvasive, Nonpharmacological Treatment for Chronic Pain closed on December 26th. To facilitate a coordinated set of comments, the Academy of Integrative Pain Management arranged a call for attendees of the Integrative Pain Care Policy Congress and other concerned advocates. Thirty-five advocates participated, helping to inform the comments written by AIPM.
And finally, in case you missed it, the consensus definition of comprehensive, integrative pain management that came out of our inaugural Policy Congress was released in November 2017.