Wednesday, March 24, 2010

Good News for Pain Care in USA Healthcare Reforms

U.S. CongressThe tens of millions of persons with pain in the United States were not forgotten in recently passed healthcare reform legislation. While it may take some time, more attention and funding will be devoted to examining critical issues and needs, researching more effective pain therapies, and providing better training for health professionals in managing pain.

The historic healthcare reform initiatives — the “Patient Protection and Affordable Care Act” — recently approved by Congress and signed into U.S. law include several provisions of earlier legislation, titled the “National Pain Care Policy Act of 2009.” This Act was approved by the House of Representatives about a year ago but was still in a Senate committee awaiting further action; however, the following components were included in Section 4305 of the new healthcare reform legislation and can now move forward:

Institute of Medicine Conference on Pain Care
Subsection 4305(a) authorizes the prestigious U.S. Institute of Medicine (IOM) to convene a special conference on pain care to:

  • Evaluate the adequacy of pain assessment, treatment, and management;

  • Identify barriers to appropriate pain care in the U.S.;

  • Establish an action agenda to reduce barriers and improve research, education, training, and clinical care;

  • Report to Congress on findings and recommendations; and

  • As a result of the report, increase awareness of pain as a significant public health problem.
National Institutes of Health Pain Consortium
Subsection 4305(b) adds a new focus on pain research to the Public Health Service Act, which charges the National Institutes of Health (NIH) with the following:

  • Requires the Director of NIH to continue and expand, through the Pain Consortium, an aggressive program of basic and clinical research on the causes of and potential treatments for pain;

  • The Pain Consortium is required to recommend to the NIH Director priority pain research initiatives;

  • Establishes an Interagency Pain Research Coordinating Committee (IPRCC) with experts drawn from government, professional, and patient groups; and

  • Requires the IPRCC, on an annual basis, to track advances in Federally-supported pain research, identify critical research gaps, and coordinate research across NIH and other government agencies.
Pain Care Education and Training
Subsection 4305(c) charges the Health Resources and Services Administration (HRSA) at the Department of Health and Human Services (DHHS) with the following:

  • Establish the definition of pain care as “the assessment, diagnosis, treatment or management of acute or chronic pain regardless of causation or body location”;

  • Authorize training grants and contracts to health-professions schools and other educational entities;

  • Emphasize training on comprehensive, interdisciplinary approaches to pain care, including attention to access and regulatory issues as well as clinical components; and

  • Require HRSA to evaluate, directly or through grants or contracts, the effectiveness of Federally-supported pain care training programs.
COMMENT: Exact timeframes and funding appropriations for the above initiatives are still unsettled; no doubt, it may take some years for these programs to be fully realized and outcomes to become reflected in the day-to-day care of patients with pain. However, this certainly seems to be a much needed start in the right direction. Left out of the new legislation was a provision in the original Pain Care Act of 2009 calling for the Secretary of DHHS to establish and implement a national pain care education outreach and awareness campaign for consumers, patients, their families, and other caregivers with respect to the many challenges and issues surrounding effective pain management. This also was intended to help reduce disparities in access to appropriate diagnosis, assessment, and treatment for populations currently underserved. Perhaps, it will be added back into the mix at a later date.

According to the American Pain Foundation (APF), there are more than 76.5 million Americans affected by pain; the majority with chronic or persistent pain of some sort. This represents a very sizable voting constituency, which has been largely neglected in the past but was definitely not overlooked in this landmark healthcare legislation. APF president Will Rowe noted in a news release, “Including the provisions from the National Pain Care Policy Act into the National Health Care Reform Bill was not only a victory for people in pain but for health care providers as well. When people have access to the pain treatment that they deserve and doctors are provided the appropriate training they are seeking to treat them, many people in pain can resume active, productive lives worth living.”

SOURCES: Information for the above blogpost was derived from the Congressional Record, the American Pain Society, and the American Pain Foundation. Also, special thanks to Robert J. Saner of Powers Pyles Sutter & Verville, PC, in Washington, DC.

> Section 4305 (ADVANCING RESEARCH AND TREATMENT FOR PAIN CARE MANAGEMENT) may be viewed in the healthcare reform document [here], starting on page 466.