More than 60 medical experts, state health directors and advocacy groups have asked federal Medicare officials to remove questions related to pain treatment from hospital patient surveys that are used to rate hospital quality, saying such questions “have had the unintended consequence of encouraging aggressive opioid use in hospitalized patients and upon discharge.”
In a letter to Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services (CMS), the group said “aggressive management of pain should not be equated with quality healthcare, as it can result in unhelpful and unsafe treatment, the end point of which is often the inappropriate provision of opioids.” The coalition asked that CMS survey questions such as “During this hospital stay, how often was your pain well controlled?” be removed. The group sent a similar letter to the Joint Commission, which accredits U.S. hospitals, asking that it revise its pain management standards – specifically, guidelines directing doctors to ask patients to assess their pain, as they assess other “vital signs.”
“Mandating routine pain assessments for all patients in all settings is unwarranted and can lead to overtreatment and overuse of opioid analgesics,” they wrote. The letters come as Connecticut and other states grapple with a surge in opioid-related overdoses. Last week, U.S. Sen. Richard Blumenthal, D-Conn., joined several other senators to support a bill that would factor-out the pain-related questions on patient surveys from hospitals’ Medicare reimbursement determinations. Meanwhile, at the state legislature, the Public Health Committee has proposed a bill that would cap initial prescriptions of opioids to seven days for acute pain.