Executive Summary of AACIPM’s November 2020 Symposium

Taking a close look at how behavioral health can be effectively utilized as part of a comprehensive approach to pain management, nearly 150 health care providers, people with pain, health insurers, and large purchasers of healthcare recently attended Behavioral Health as a Part of Comprehensive Pain Care and Payment Design, a virtual symposium hosted by the Alliance to Advance Comprehensive Integrative Pain Management in partnership with the American Psychological Association.

Providing optimal care in light of the challenges presented by COVID-19 was at the forefront of nearly everyone’s mind. In kicking off the event, Denise Giambalvo, Vice President of the Midwest Business Group on Health, stated that U.S. drug overdoses have resurged to record highs in the shadow of the pandemic, pointing to the need to both utilize non-opioid treatments for pain when possible, as well as the need for improved identification and treatment of substance use disorders. Following up, Robin Kahn, Director of Health and Benefits at Willis Towers Watson, discussed the dire effects of the pandemic on mental health, stating that 92% of employees have reported anxiety this year, going on to remind attendees that increased stress and anxiety worsen chronic pain. Further, Ms. Kahn highlighted the confusion among employers as purchasers of healthcare – there is no clear pathway to integrate behavioral health between medical coverage, employee assistance programs and other wellness offerings. She ended with some questions, “How do you then connect all of the dots, let alone help a person find the right care? If I need help, who do I call? Where do I begin? How do I know that just because they’re in network, that they’re the best solution for me? So unfortunately, there’s no single solution a lot of times for the individuals and not for the employer either.”

Aside from pandemic-related issues, attendees of the symposium reviewed the impact and prevalence of pain, the standards and competencies necessary to effectively provide behavioral health interventions to people with chronic pain, and learned about the potential effectiveness of integrating behavioral health from the perspective of both health care providers and people living with chronic pain. As stated by Stephen Gillaspy, PhD, the Senior Director of Health Care Financing for the American Psychological Association, the need for improved access to comprehensive pain management exists outside of both the pandemic and the opioid crisis, which is why the APA is working to both expand the number of psychologists trained to provide pain management services and ensure adequate reimbursement and insurance coverage policies to support universal access to appropriate behavioral and psychological pain management services. These efforts were supported by the words of Yvette Colón, PhD, a Clinical Social Worker and Professor at Eastern Michigan University, who stated that behavioral health services for pain are often seen as a “treatment of last resort”, which is contrary to data that illustrates that earlier intervention and coordination of services results in improved patient outcomes.

Interestingly we were able to hear from other payors who emphasized the importance of patient-centric care, metrics and value based payment models as well as understanding the impact of social determinants of health when we’re applying the biopsychosocial model of care. And we also heard about distinctions between health coaching, patient navigation and behavioral health from Ruth Wolever, PhD, NBC-HWC, Director of Osher Center for Integrative Medicine at Vanderbilt.  All the presenters agreed that a whole person perspective is necessary and what works for some may not work for others – so widening the net of evidence-based options is key as is collaboration between providers and payors.  The goal is to access the right care at the right time for the right person.

To see the agenda, full list of speakers and their bios, and a recording of the event, please visit: https://painmanagementalliance.org/bhp

The Alliance to Advance Comprehensive Integrative Pain Management would like to offer special thanks to our primary sponsor, the David and Lura Lovell Foundation, for making this event possible.