by Myra Christopher, PAINS Director

Wednesday, November 2, I began my presentation about the National Pain Strategy to the Centers for Medicare and Medicaid Services’ Consortium for Quality Improvement & Survey & Certification Operations (CQISCO) by saying, “I’ve been waiting and waiting and waiting to talk to you….” The conference at which I spoke was the 2017 CQISCO Collaborative:  The Opioid Crisis and Chronic Pain Management.  I was very excited about this opportunity for several reasons:

  1. The CQISCO serves as the field focal point for all quality, clinical and medical science issues and policies for CMS’ programs. Provides leadership and coordination for the development and implementation of a cohesive, CMS-wide approach to measuring and promoting quality and leads CMS’ priority-setting process for clinical quality improvement. Coordinates quality-related activities with outside organizations. Monitors quality of Medicare, Medicaid, and the Clinical Laboratory Improvement Act (CLIA). Evaluates the success of interventions.
  2. I have come to believe that the way to move implementation of the National Pain Strategy forward is by positioning it as a key strategy in addressing the opioid crisis.
  3. Until reimbursement is aligned with the provision of comprehensive/integrative chronic pain care, the shift from a biomedical to a biopsychosocial model of chronic pain care will not occur.
  4. Conference planners had intentionally included leaders in the pain space in their agenda.

PAINS was well represented.  I had the privilege of being the “kick-off” speaker, one of PAINS Citizen/Leader Advisors – Ken Babb spoke about his experience living with chronic pain, as did two of PAINS Advisory Committee members – Bob Twillman (Executive Director of the Academy of Integrative Pain Management) spoke about integrative/comprehensive chronic pain care and Kim Nelson (SAMHSA, Region VII Administrator) spoke about SAMHSA’s efforts to address the opioid epidemic and funding they are providing.

Dr. Renard Murray, CQISCO Administrator, began the meeting by speaking about the need for more collaboration.  In his opening remarks, he reminded those present that Henry Ford once said, “Coming together is a beginning.  Keeping together is progress.  Working together is success.”

We must have demonstration projects proving the effectiveness of and sustainability of comprehensive chronic pain care programs.  In 2000, there were more than 1,000 such centers.  By the time the Institute of Medicine published Relieving Pain in America, there were only 122 such programs to be identified.  The reason for this was that the care provided was not reimbursed.  At an HHS meeting a few months ago, Steven Stanos, MD, who directs a comprehensive pain management program at Swedish Hospital in Seattle talked about the financial challenges they face and said that were the hospital’s leadership not fully committed to this patient population, he did not know if they could provide the care their patients need.

We are grateful for the opportunity to “come together” with CMS leaders focused on quality care for people living with opioid abuse disorders and those living with chronic pain.  PAINS is committed “keeping together” to encourage and assist the CQISCO to develop and implement a cohesive, CMS-wide app toroach to measure and promote quality comprehensive/integrative pain care and to establish it as a priority for clinical quality improvement.  It is our goal to “keep together,” “work together” and to be successful.

NB:  PAINS has asked for slides of other presenters.  They are currently in the clearance process but with permission, we will share them with you.