People with Pain, Payers, Clinicians, and Industry Discuss CMS Pain Codes + Scaling Transdisciplinary Pain Care

Webinar Date: December 7, 12:00-2:00 PM ET

On behalf of the Alliance to Advance Comprehensive Integrative Pain Management and the US Pain Foundation, we invite you to join this lively and constructive discussion about the intersection of payer policies and value-based care delivery for high-impact pain.
 
Register now for this no-cost webinar, Exploring Equitable, Scalable, Value-Based Pain Care Delivery, and share this survey with your networks to help gather feedback before the program.
 
In light of CMS’ laudable goal for Medicare and Medicaid beneficiaries to be in value-based care relationships by 2030, we will take a deeper dive to explore the real-world impact of this goal and the paths toward successful implementation. This program will look into the most recent pain management codes released by CMS in January 2023 and how these are playing out in various clinical settings. Further, our esteemed panelists (see their bios) each bring a unique perspective and practical expertise to the conversation with an understanding of the nuances of how payer policies impact clinical—and scalable—implementation of pain care policy.
 
Participants in this free webinar will learn about:

• CMS efforts to advance value-based care, including the new CMS pain codes – what these are, what they mean, and how the first year since their release is going.
• Public and private sector innovation advancing access to transdisciplinary pain care for people who are underserved.
• Value-based care innovation that offers a network of chiropractors, acupuncturists, nutritionists, massage therapists, health coaches, and naturopaths.
• An example of family practice in rural Georgia and how the CMS codes impact value-based care delivery.

Whether or not you can attend the webinar, your feedback is crucial to webinar development, so please take a few minutes to complete this survey and/or share it with your networks.

National Updates

American Psychological Association Accepting Public Comment on Draft Guidelines for Chronic Musculoskeletal Pain in Adults

The American Psychological Association (APA) is currently accepting public comments on its Draft APA Clinical Practice Guideline for the Treatment of Chronic Musculoskeletal Pain in Adults. The guideline focuses on recommendations for psychological, pharmacological and other common interventions for treatment of chronic musculoskeletal pain. It was based upon three systematic reviews and was developed by an APA guideline development panel composed of scientists, clinicians, and client/community representatives. All interested individuals and groups are invited to comment, including psychologists, health care professionals, researchers, clients/patients and their families, APA governance members, and the general public.

Interested in Providing Your Thoughts? AACIPM has received an invitation to comment on these guidelines. While we are putting together our response, we would be happy to hear from you regarding your thoughts on the draft guideline. Please share your feedback with amy@painmanagementalliance.org by November 17.

All comments must be submitted no later than 11:59 pm, Eastern Time, on Monday, December 4, 2023.

VA Launches Study on Group-Based Psychological Treatments via Teleconference for Older Veterans with Chronic Pain

Current guidelines for treating chronic pain from the U.S. Department of Veterans Affairs (VA) emphasize psychological treatments as first-line therapy, yet most currently available options have only been shown to provide modest benefits. To increase effectiveness, the VA will be conducting a four year study to test a number of treatment options, including Emotional Awareness and Expression Therapy (EAET), group and video telehealth delivered treatments, and identification of mechanisms of response so that the most effective treatments are selected for each patient. The trial focuses on older Veterans, a currently understudied subset of patients living with chronic pain. Following the trial, the VA plans to share resources on treatments, findings, and lessons learned with both VA clinicians and the broader scientific community.

Administration on Aging Fully Funds Eight Chronic Disease Self-Management Education Programs

Aimed at providing older adults and adults with disabilities with education and tools to help them better manage chronic conditions such as diabetes, heart disease, arthritis, chronic pain, and depression, Chronic Disease Self-Management Education (CDSME) programs have been supported by the Administration on Aging (AoA) for the past twenty years. Grantees provide a number of activities and community services through use of these grants, including: partnering with local agencies on aging, local health departments, rural clinics, and hospitals; implementing self-management programs people living with chronic pain and opioid abuse/misuse; and, securing reimbursement via Medicare, Medicare Advantage, and Medicaid.

In 2023, the AoA awarded 8 fully-funded cooperative agreements totaling nearly $5 million. New grantees include programs located in Michigan, Georgia, Mississippi, New Mexico, New York, and Texas.

ICYMI

Telemedicine Temporary Rules to Expire November 11

In May, the U.S. Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) issued a temporary rule that extended telemedicine flexibilities adopted during the COVID-19 Public Health Emergency. Beginning November 11, 2023, these flexibilities will no longer apply to new patients seeking telemedicine. However, for any practitioner-patient telemedicine relationships that have been or will be established up to November 11, 2023, the full set of telemedicine flexibilities regarding prescription of controlled medications established during the COVID-19 PHE will be extended for one-year—through November 11, 2024.

Message from the Director

Here we are entering the final two months of 2023! I hope this newsletter finds all of you well and with time for self-care during these busy times.

I’m very enthusiastic about our next webinar on December 7 and hope that you will register and share this information with your networks. We also have a survey that is an important advocacy tool for connecting feedback from patients and providers with CMS and other policymakers. The survey results will be shared during the webinar so that we can identify action steps.

Implementation is the key to positive change and we want to help promote the uptake of comprehensive integrative pain management for all people. 

Onward and Upward!
Amy

Relevant Reading

Emotional responses to favorite and relaxing music predict music-induced hypoalgesia, Frontiers in Pain Research, October 25

Nature exposure therapy for pediatric patients with chronic pain, Contemporary Pediatrics, October 20

What Is Whole Person Health? A Beginner’s Guide to the Interconnectedness of Body, Mind, and Your Environment, Everyday Health, October 19

Mindfulness Should Not Be Taught in School? Really?, Psychology Today, October 18

PODCAST: Millions of people have unexplained chronic pain. Can scientists help?, Economist, October 18

Comprehensive Programs Are Needed to Address Therapeutic Needs in Sickle Cell Disease, OncLive, October 12

How to make workplaces more inclusive for people with invisible disabilities, Fast Company, October 1

A Randomized, Controlled Neuroimaging Trial of Cognitive-Behavioral Therapy for Fibromyalgia Pain, American College of Rheumatology, September 20

The Alliance to Advance Comprehensive Integrative Pain Management (AACIPM) and National Pain Advocacy Center (NPAC) extend sincere gratitude to Cornell University for hosting an extremely timely and important workshop, Digital Pain Technologies: Promises and Problems, from May 1-2, 2023. Organized by Cornell’s Benjamin Lipp and Stephen Hilgartner from the department of Science & Technology Studies, the workshop brought together academics from social science and technical disciplines, along with health professionals, patient advocates, and companies, around the issue of designing systems of pain management that are more equitable, accessible, and integrated.

Current and converging trends in pain management include an abundance of new and emerging digital interventions, and this raises many questions when thinking about person-centered pain management. These include and often combine digital applications that monitor pain symptoms and behaviors, new generations of wearable neuromodulation devices, as well as telehealth platforms. Next to pain relief, these technologies share the goals of empowering patients outside the clinic, providing better access to care especially in rural areas, and offering new kinds of data to providers as well as patients. However, while there are many success stories and promising products, their prospective integration into new systems of pain management raises a range of ethical, political, and technical questions, such as:

• How does the availability of digital pain data impact communication between patient and provider?
• Whose claims about pain does digital pain data harness and whose do they discredit?
• What new kinds of vulnerabilities emerge at the device-body interface, such as data leakages or safety issues?
• Does digital integration make pain management more accessible or produce new inequities?

Among a select group of 15 experts, NPAC Director Kate Nicholson, JD, and AACIPM Director Amy Goldstein, MSW, were invited to add to the workshop’s trans-disciplinary dialogue. While having time together in Ithaca, we decided to co-write this blog to be efficient and help build momentum more broadly. Kate presented Equity, Access & Privacy in Remote Care: Pitfalls and Opportunities; Amy presented Unpacking equitable, whole person, multimodal pain care in the context of responsible, real-world solutions.  

Other participants raised a number of other ethical, policy, and digital concerns that made participants reflect on digital interventions from a more nuanced viewpoint. The collective interest in this workshop was palpably strong and, by workshop’s end, there was unanimous support in participating in next steps, such as a joint statement from the participants and a follow-on meeting. 

About her time at the workshop, Amy Goldstein, Director, AACIPM said:

“I am so enthusiastic about the next steps after participating in this workshop!  We covered a lot of ground among leaders who sincerely wanted to listen, discuss, and learn from other experts – all to focus on designing responsible systems of pain management that are more equitable, accessible, and integrated. We want to build momentum by continuing to connect more dots.”