by Denise Giambalvo, VP at MBGH and Amy Goldstein, Director at AACIPM

The Alliance to Advance Comprehensive Integrative Pain Management (AACIPM) and the Midwest Business Group on Health (MBGH) convened its first Health Care Purchasers Focus Group on March 4 in Chicago. The event brought together employers, employer coalitions and policy and clinical subject matter experts to discuss comprehensive integrative pain management (CIPM).

Pictured (left to right): David Elton, United Health Ventures; Alyssa Wostrel, AACIPM; Leah Hole Marshall, Washington Health Benefit Exchange; Amy Goldstein, AACIPM; Daniel Blaney-Koen, American Medical Association; Christine Goertz, Duke University; Lance Luria, Mercy Care Management; Kavitha Reddy, Veterans Health Administration

The Focus Group was held to educate and learn from savvy employers interested in a comprehensive treatment approach to pain management for improved productivity and quality of life for employees and covered beneficiaries. Access to evidence-based, high-quality treatment options is critical for employees and family members, especially in light of changing policies related to curbing opioid misuse and overdose. To get there, employers must understand the bigger picture of the toolbox needed for pain management and impact to the productivity and quality of life of their employees and communities. Presenters shared information from different perspectives to illustrate how pain management can be provided that conforms to current clinical practice guidance and supports quality outcomes and manages costs.

MBGH sent a pre-meeting survey to its employer members, representing mid, large and jumbo employers across industries, to gain insights about experiences with managing costs and benefits for pain care. Some highlights include:

• Low back pain is one of the most common reasons for physician visits and the most common cause of job-related disability. Twenty-seven percent of survey respondents reported a percent of total annual health care spend related to musculoskeletal pain between 5-10% with another 24% of respondents spending between 16-20%.
• There is significant variability in reported insurance coverage of integrative therapies even though the American College of Physicians published clinical practice guidelines recommends various non-pharmacological therapies for low back pain. Respondents noted that physical therapy was the most covered benefit followed by chiropractic, acupuncture, behavioral health and therapeutic massage. No respondents reported coverage for yoga or reiki.
• Employer respondents reported inconsistencies with their processes to manage health care cost and quality. Some reported they have only been able to manage costs.

Following the presentations and interactive discussions, employer participants indicated that the dialogue was helpful and informative. Several reported key takeaways and action steps they planned to implement as a result of the information provided, such as asking different questions about their company’s pain management benefit plans.

Focus Group presenters included: Kavitha Reddy, MD, Whole Health System Clinical Director, VA St. Louis Healthcare System, Veterans Health Administration; David Elton, DC, Chief Strategy Officer, United Health Ventures; Robert Bonakdar, MD, Pain Management Director, Scripps Center for Integrative Medicine; Christine Goertz, DC, PhD, Professor in Musculoskeletal Research, Duke University; Leah Hole Marshall, JD, Chief Strategy Officer, Washington Health Benefit Exchange. Other leaders and advisory members of AACIPM that participated in the discussion included: Lance Luria, MD, Chief Medical Officer, Mercy Care Management; Daniel Blaney-Koen, JD, Senior Legislative Attorney, American Medical Association; Amy Goldstein, MSW, Director, AACIPM; and Alyssa Wostrel, Executive Director, Academic Collaborative for Integrative Health.

On behalf of national and state employer coalitions, participants included Margaret Rehayem, Director of Initiatives & Programs, National Alliance of Healthcare Purchaser Coalitions; Cheryl Larson, President, and Denise Giambalvo, Vice President for MBGH; and Natalie Middaugh, Community Health Program Manager for the Kentuckiana Health Collaborative.

A more detailed summary will be coming soon and there are plans in place to focus on action steps to continue this important work.