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CMS Proposes Eliminating Pain Management from Patient Satisfaction Surveys

Members of the Kentucky Medical Association’s Public Health Commission in June proposed a resolution to support removal of pain management from surveys on patient satisfaction when released from the hospital.

The Centers for Medicare and Medicaid Services (CMS) on July 6 issued a proposed rule for the 2017 Hospital Outpatient Prospective Payment System that would do just that. CMS is accepting comments on the rule through Sept. 6, just days before the KMA 2016 Annual Meeting will take place.

Danesh Mazloomdoost, MD, a pain management specialist from Lexington and KMA Public Health Commission member, said one of the biggest problems surrounding prescription drug abuse is a lack of understanding by the public about what an opioid does.

There is a belief, he said, that “life is pain-free and if it’s not, there’s a chemical solution for it.”

That often leads to prescriptions that add to the problem of prescription drug abuse, Dr. Mazloomdoost said.

“Kentucky is the epicenter of the opioid problem,” said Vaughn Payne, MD, a member of the commission. “We’ve got a real problem everywhere.”

Deborah Ballard, MD, said other alternatives for addressing pain can be found through integrative medicine. “We have such a huge repertoire of how we can manage chronic pain,” she said.

Questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) in the value-based purchasing program ask patients if they needed medicine for pain, how often their pain was well controlled and – of most concern to the healthcare industry – if the hospital staff did everything they could to help with the pain.

“Some stakeholders believe that the linkage of the pain management dimension questions to the Hospital VBP program payment incentives creates pressure on hospital staff to prescribe more opioids,” the CMS said in the proposed rule. The agency said removing the questions from the survey would “mitigate even the perception that there is financial pressure to overprescribe opioids.”

The CMS proposal addresses concerns from several prominent health care associations that had called on the Obama administration to stop incorporating patients’ responses to pain-management questions in the HCAHPS. Assessment results are a significant factor in how hospitals fare under value-based purchasing, and providers have complained the program gives them a financial incentive to over-prescribe painkillers to keep patients happy.

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