The practice of pain management has grown considerably in recent decades. With the onset of healthcare reform, increased awareness and education about pain and a growing workforce within pain management, the specialty is not only projected to grow but also faces changes going forward into 2011. Vishal Lal, CEO of Advanced Pain Management based in Greenfield, Wis., shares five trends pain management-driven ASCs can expect to see in 2011.
1. Increased technology and more advances in the pain management field. The scope of pain management procedures and treatments have grown dramatically in recent years, and Mr. Lal says all the commitment to research in the specialty will only lead to more advances in technology and new procedures in pain treatments.
"The awareness of the practice of pain management is growing by leaps and bounds, and the scope of the procedures is expanding too," he says. "For example, there have recently been newer options with implant devices, such as spinal cord stimulators and pumps. These have been around the block, but now there is more technology that helps us to achieve goals for the reduction of pain. Physicians are also able to do lumbar facet fusions, if need be."
2. Increased difficulty in authorization for newer procedures. Mr. Lal says that although he doesn't expect any more dramatic decreases in Medicare reimbursements for pain management procedures, it will certainly become more difficult to get authorization for procedures using newer technology.
"All of this new technology is coming out the door and there are promising results, but it's hard to get authorization for these procedures by insurance companies," he says. "So the challenge in providing these newer and more modern procedures to patients is that patients may pay more out-of-pocket."
However, there are small victories along the way for pain management specialists who are struggling to overcome difficult authorizations for newer and more beneficial procedures. "TriCare just started accepting some of the newer procedures, and that's a huge win for the industry," Mr. Lal says. "The more tools that are there to offer to patients, the better they are going to be because the alternative is inpatient surgery, which is costlier."
3. Additional expenses going toward technology. As more advancements are made in the field of pain management, and newer technology continues to come down the pipeline to facilitate those procedures, ASCs may be faced with the possibility of spending significant amounts of money on adopting newer procedures and their associated technology.
"One of the challenges pain management ASCs may face is covering the cost of procedures that use more modern technology," he says. "Some procedures require huge technology costs, and sometimes ASCs may not be able to make up the difference after Medicare's reimbursement of the procedure's cost. So even if an ASC is able to get the authorization to do a certain procedure, they have to see if they have enough money in their contracts to cover the technology-related costs."
4. Growing patient population with pain-related conditions. ASCs specializing in pain management can also expect to see more patients visiting their facilities. Mr. Lal says the growing trend of an aging population as well as obesity rates in the country will likely expand patient volumes at pain management-driven ASCs.
"That's why I see the pain management expanding even more, because of obesity trends and the aging population," he says. "These two trends are going to require more pain management in years to come because people are naturally going to have more pain. Patients' options for pain management care were not as readily available in the past, and going forward the industry is only going to grow."
5. Increased scrutiny over prescription of Schedule II drugs. Because the country is experience alarmingly high rates of addiction to narcotics and death by overdosing on Schedule II drugs, pain management ASCs can expect to see increased government scrutiny over how these controlled substances are prescribed, who prescribes them and to whom they are prescribed. Mr. Lal says pain management ASCs should be aware of this and he suggests incorporating practices to ensure patient care is carried out without the use of narcotics.
"There is a tremendous overuse of Schedule II drugs, and there is widespread abuse stemming from it," he says. "We are a pain management practice that really tries to lower patients' need for these narcotics. Patients who have acute or chronic pain typically are on high doses of narcotics, but we're trying to bring in more physical therapy and coping techniques to help reduce the amount of medication they may need to take on a daily basis."
In preparation for a situation where first-line treatment of pain without the use of narcotics isn't as effective, Mr. Lal also suggests training staff adequately so prescription medications are distributed properly. "ASCs want to make sure their staff members are sufficiently trained in giving the right amount of narcotics so they are appropriately taken while also improving the quality of life."
Learn more about Advanced Pain Management.
1. Increased technology and more advances in the pain management field. The scope of pain management procedures and treatments have grown dramatically in recent years, and Mr. Lal says all the commitment to research in the specialty will only lead to more advances in technology and new procedures in pain treatments.
"The awareness of the practice of pain management is growing by leaps and bounds, and the scope of the procedures is expanding too," he says. "For example, there have recently been newer options with implant devices, such as spinal cord stimulators and pumps. These have been around the block, but now there is more technology that helps us to achieve goals for the reduction of pain. Physicians are also able to do lumbar facet fusions, if need be."
2. Increased difficulty in authorization for newer procedures. Mr. Lal says that although he doesn't expect any more dramatic decreases in Medicare reimbursements for pain management procedures, it will certainly become more difficult to get authorization for procedures using newer technology.
"All of this new technology is coming out the door and there are promising results, but it's hard to get authorization for these procedures by insurance companies," he says. "So the challenge in providing these newer and more modern procedures to patients is that patients may pay more out-of-pocket."
However, there are small victories along the way for pain management specialists who are struggling to overcome difficult authorizations for newer and more beneficial procedures. "TriCare just started accepting some of the newer procedures, and that's a huge win for the industry," Mr. Lal says. "The more tools that are there to offer to patients, the better they are going to be because the alternative is inpatient surgery, which is costlier."
3. Additional expenses going toward technology. As more advancements are made in the field of pain management, and newer technology continues to come down the pipeline to facilitate those procedures, ASCs may be faced with the possibility of spending significant amounts of money on adopting newer procedures and their associated technology.
"One of the challenges pain management ASCs may face is covering the cost of procedures that use more modern technology," he says. "Some procedures require huge technology costs, and sometimes ASCs may not be able to make up the difference after Medicare's reimbursement of the procedure's cost. So even if an ASC is able to get the authorization to do a certain procedure, they have to see if they have enough money in their contracts to cover the technology-related costs."
4. Growing patient population with pain-related conditions. ASCs specializing in pain management can also expect to see more patients visiting their facilities. Mr. Lal says the growing trend of an aging population as well as obesity rates in the country will likely expand patient volumes at pain management-driven ASCs.
"That's why I see the pain management expanding even more, because of obesity trends and the aging population," he says. "These two trends are going to require more pain management in years to come because people are naturally going to have more pain. Patients' options for pain management care were not as readily available in the past, and going forward the industry is only going to grow."
5. Increased scrutiny over prescription of Schedule II drugs. Because the country is experience alarmingly high rates of addiction to narcotics and death by overdosing on Schedule II drugs, pain management ASCs can expect to see increased government scrutiny over how these controlled substances are prescribed, who prescribes them and to whom they are prescribed. Mr. Lal says pain management ASCs should be aware of this and he suggests incorporating practices to ensure patient care is carried out without the use of narcotics.
"There is a tremendous overuse of Schedule II drugs, and there is widespread abuse stemming from it," he says. "We are a pain management practice that really tries to lower patients' need for these narcotics. Patients who have acute or chronic pain typically are on high doses of narcotics, but we're trying to bring in more physical therapy and coping techniques to help reduce the amount of medication they may need to take on a daily basis."
In preparation for a situation where first-line treatment of pain without the use of narcotics isn't as effective, Mr. Lal also suggests training staff adequately so prescription medications are distributed properly. "ASCs want to make sure their staff members are sufficiently trained in giving the right amount of narcotics so they are appropriately taken while also improving the quality of life."
Learn more about Advanced Pain Management.