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4 Articles in this Series
Introduction
AIPM 2017 Video Highlights
Cannabinoids versus Opioids for Chronic Pain Care
Congress Seeks Consensus on Policy Coverage for Integrative Medicine
Could Systemic Lidocaine be the New Standard of Care for Pain due to Inflammation?

Congress Seeks Consensus on Policy Coverage for Integrative Medicine

Over the course of eight hours between October 21 and 22 in San Diego, California, members of 50-plus health and policy organizations are aiming to come to a consensus surrounding the issue of integrative pain care and crucial changes needed in policy coverage of this growing approach. This first-ever Integrative Pain Care Policy Congress will include certified health professionals involved in pain care, as well as insurers, people with pain, researchers, and policymakers. Hosted as part of the Academy of Integrative Pan Management’s (AIPM) 28th Annual Meeting, the Congress is being held in partnership with the Integrative Health Policy Consortium, the PAINS Project, and the Alliance for Balanced Pain Management.

The Congress is at the forefront of the country’s focus on the opioid crisis, including a pending announcement regarding a national strategy from the President, and a widening focus on alternative approaches to pain management. At the same time, thousands of patients who have been using opioids to successfully cope with chronic pain for years (“legacy patients”), and their pain specialists, are fighting to ensure their voices are heard.

Practical Pain Management spoke with W. Clay Jackson, MD, DipTh, who is serving as a facilitator of the Congress, along with AIPM Board Member Kevin Galloway, just before the opening of the Congress. Dr. Jackson is vice president of the AIPM Board and a clinical assistant professor of family medicine and psychiatry at the University of Tennessee College of Medicine in Memphis, where he maintains a private practice in family and palliative medicine.

In addition to achieving consensus on a definition for comprehensive, integrative pain care, Dr. Jackson noted that the group will seek to draft agreed-upon metrics for reported patient outcomes and work to develop a meaningful action plan for moving forward in 2018. This action plan will likely include a whitepaper that Congress participants can share with their constituents across the country, but also submit to policy stakeholders in the private and public sphere to assist in their decision-making on coverage for patients with chronic pain.

Clay Jackson, MD, Integrative Care Congress FacilitatorClay Jackson, MD, Integrative Care Congress Facilitator

The challenge, said Dr. Jackson is to bring all of these players, representing different constituencies in the healthcare space, together. Essentially, “we are establishing a coalition of interested stakeholders that will shepherd the process of beginning research collaboratives, reporting metrics, and launching additional pilot programs for integrative pain models that will improve ways to practice as well as improve available access” to those in need. In the end, he added, all participants “should all feel good about advocating for this type of care to be standard care in any standard insurance plan.”

In an AIPM press release about the Congress, further goals were noted regarding the need to address current policy: “The growing number of well-intentioned pain management guidelines and policies — both state and federal — are impacting the health care that is available to those in need of acute and chronic pain management. These policies have good intentions, but the complexity created by overlapping efforts has resulted in conflicting stakeholder recommendations, in many instances prolonging pain and encouraging addiction.”

It’s a “thorny problem across the country,” explained Dr. Jackson. “People with chronic pain can’t find good pharmacologic treatment much less good nonpharmacological treatment, and there are too many discrepancies in coverage, which adds to the difficulty faced by patients and physicians. For many, the barrier is insurmountable.”

“The reality is that there is a dual crisis: opioid prescribing and under-treatment of chronic pain,” he added. “Some solutions exacerbate the latter. We think integrative care, with help from all players in the field, can mitigate both crises.”

As for raising awareness of the current opioid crisis and the debates at stake, Dr. Jackson asks the community at large not to stigmatize patients who have chronic pain. “They deserve incredible, effective care and we’re working hard as clinicians to qualify what that care is and what the best outcomes are. Policymakers need to work with us to allow integrative policy reimbursement to drive better care.”

Overall, he added, “chronic pain is a bio-psycho-social illness, and yet, we currently treat it only biologically at our peril and patients’ peril. Going forward, we have to take into account all the components in an integrative way to achieve the best possible outcomes.”

Practical Pain Management will share the results of the Congress when they are released.

Next summary: Could Systemic Lidocaine be the New Standard of Care for Pain due to Inflammation?
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