AMA: Delink patient pain surveys and facility payments

During its annual meeting last week in Chicago, the American Medical Association (AMA) took square aim at the much-maligned procedure of linking patient pain management surveys with payments to healthcare facilities. The call to end the practice was one of several policies adopted during the meeting.

The AMA says aiming for eradication of pain puts undue pressure on clinical pain management practices, which can ultimately encourage the overuse of opioids, especially because other approaches are not covered by insurance.

“We believe it is critical for hospitals and physicians to get feedback from patients regarding their care, but the issue of linking the specific questions about pain to reimbursement is not the way to go with the way the questions are currently asked,” Patrice A. Harris, MD, chair of the AMA Board of Trustees and the AMA Taskforce to Reduce Opioid Abuse, tells Addiction Professional. “It potentially drives the overuse of pain medications, particularly opioids.

“We’re not saying you shouldn’t ask patients if their pain was treated, but it’s the question and linking that question to payment.”

The AMA adopted two additional opioid-related policies during its event:

• Encourage physicians to co-prescribe naloxone to patients at risk of overdose;
• Promote timely and appropriate access to non-opioid and non-pharmacologic treatments for pain.

These policies from the AMA are in line with the organization’s previous calls for improving access to naloxone for properly trained first responders, as well as friends and family who might be put into position to save lives. In a June 2015 article posted to the AMA’s website, Harris noted the AMA had supported 20 such laws in the previous two years.

“That message still applies,” Harris says. “Our taskforce has been working on this for 16 or 17 months now. Regarding naloxone, the issue is continuing to support our state medical associations as they work with their state legislators to increase access. Certainly there are states where we need some additional work regarding Good Samaritan laws. I think it’s just the continued partnership and working together to get the issues addressed at the state level.”

Of the 47,055 drug overdose-related deaths in the U.S. in 2014, 28,647 involved some type of opioid, including heroin, according to a Morbidity and Mortality Weekly Report published in January by the Centers for Disease Control and Prevention (CDC).

The AMA’s new policies promote increased access to naloxone, and encourage private and public payers to include all forms of the medication on their preferred drug lists and formularies with nominal or no cost sharing.

Tom Valentino is Senior Editor for Addiction Professional.