The following is a summary of “Overcoming Barriers to the Implementation of Integrated Musculoskeletal Pain Management Programs: A Multi-Stakeholder Qualitative Study,” published in the May 2023 issue of Pain by Lentz et al.
Integrated pain management (IPM) programs can reduce the substantial burden of musculoskeletal pain on population health, but they are inadequately implemented. Existing programs can serve as a resource for initiatives to expand IPM implementation. This qualitative study describes how healthcare systems, payers, providers, health policy researchers, and other stakeholders overcome obstacles to developing and maintaining IPM programs in real-world settings. From February 2020 to September 2021, primary data were collected from a multi-sector expert panel of 25 stakeholders, 53 expert interviews representing 30 unique IPM programs across the United States, and 4 original case studies of exemplary IPM programs.
Researchers use a consensus-based team approach to analyze qualitative findings systematically. They identified four main challenges and potential solutions for implementing IPM programs: navigating coverage, payment, and reimbursement; implementing organizational change; presenting a business case to stakeholders; and overcoming regulatory obstacles. Group visits, linking visits between billable and nonbillable providers, and developing value-based payment models were employed to address payment challenges.
Strategies for organizational change included the recruitment of clinical and administrative champions and the colocation of services. Business case strategies required demonstrating the ability to break even initially and the potential to reduce downstream costs and enhance non-financial outcomes such as patient satisfaction and provider burnout. Innovative credentialing techniques enabled expanding access to IPM services by leveraging available waivers and managed care contracting. Existing program lessons guide the developing and sustaining of IPM delivery models in various contexts.
Source: sciencedirect.com/science/article/pii/S1526590023000081
