To combat opioid epidemic, HHS moves to remove pain management questions from HCAHPS surveys
Many clinicians report feeling pressure to overprescribe opioids because scores on the pain management questions are tied to Medicare payments.
Breaking the link between Medicare payments to hospitals and the scores on the pain management questions on the Hospital Consumer Assessment of Healthcare Providers and Systems survey is among the measures the federal government is proposing to combat the opioid epidemic.
The Centers for Medicare and Medicaid Services is proposing to remove the HCAHPS survey pain management questions from the hospital payment scoring calculation, the agency said Wednesday.
Many clinicians report feeling pressure to overprescribe opioids because scores on the HCAHPS survey pain management questions are tied to Medicare payments to hospitals, CMS said.
[Also: Collaboration on incentives needed to curb opioid epidemic, Cigna says]
While the payments have a limited connection to the pain management questions on the HCAHPS survey, to mitigate even the perception of financial pressure to overprescribe opioids, CMS is proposing to remove the HCAHPS survey pain management questions from the hospital payment scoring calculation.
This means that hospitals would continue to use the questions to survey patients about their in-patient pain management experience, but these questions would not affect the level of payment hospitals receive.
Other measures to combat addiction include a final rule on access to buprenorphine, a medication to treat opioid use disorder. It allows practitioners who have waivers to prescribe buprenorphine for up to 100 patients for a year or more to now treat up to 275 patients.
[Also: American Medical Association adopts policies aimed at reversing opioid epidemic]
A third measure is for the Department of Health and Human Resources to require Indian Health Service prescribers and pharmacists to check state prescription drug monitoring program databases before prescribing or dispensing opioids for pain.
While many Indian Health Service clinicians already use PDMP databases, opioid prescribers and pharmacists will also be required to check their state PDMP database prior to prescribing or dispensing any opioid for more than seven days.
The new policy is effective immediately for more than 1,200 Indian Health Service clinicians working in IHS federally operated facilities who are authorized to prescribe opioids.
What's really needed is for Congress to approve President Obama's $1.1 billion budget request for the work, according to HHS Secretary Sylvia Burwell.
"The opioid epidemic is one of the most pressing public health issues in the United States. More Americans now die from drug overdoses than car crashes, and these overdoses have hit families from every walk of life and across our entire nation," Burwell said.
In addition, the Department of Health and Human Services is launching more than a dozen new scientific studies on opioid misuse and pain treatment and asking for feedback to improve and expand prescriber education and training programs.
The actions announced Wednesday build on an earlier Opioid initiative launched in March that is focused on improving opioid prescribing practices; expanding access to medication-assisted treatment; and increasing the use of naloxone to reverse opioid overdoses.
They also build on the national pain strategy put forward by the federal government in its first coordinated plan to reduce the burden of chronic pain.
Twitter: @SusanJMorse
