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What is the Chronic Pain Population Management Program?
The Chronic Pain Population Management program is a special Kaiser Permanente program which involves segmenting Health Plan members with chronic pain into three groups with different care needs and objectives. Each group’s needs correspond with three levels of care. As patients’ conditions change, improve or deteriorate, they may move between levels. A Chronic Pain team will determine treatment based on the level of impairment. The goal at each level is to implement proactive, planned interventions to maximize health and patient satisfaction, and increase appropriate utilization.
What are the services offered for each level of care?
Prevention and self-care provide the foundation for all levels of care. These include use of the Healthwise Handbook, Healthphone, KP Online, and the printed Preventive Health Prompt to help members stay up-to-date on their prevention screenings and immunizations and promote healthy lifestyles.
Level 1 or Self-Care Support assists members with low level chronic pain impairment in developing self-management skills by providing sound clinical management and self-care education. Adult Primary Care (APC) team care, individual or group education, group appointments, and member outreach support patients at this level.
Level 2, also known as Care Management, assists members with moderate to severe chronic pain combined with mild to moderate levels of depression and/or anxiety, physical deconditioning, and increased pain medication use.
The Chronic Pain Care Management Program (CPCM) offers assessment, medication management/consultation, education, physical therapy, psychological services and telephone and face-to-face visits as needed. At the core of the CPCM is a behaviorally based group intervention (25-40 hours over 2-3 months). During the group intervention, routine care is provided by the primary care physician and medications may be prescribed by the pain program physician. After the group intervention, the primary care physician resumes pain medication management. Additional services are provided via phone calls from the care manager and group appointments.
Level 3 or Intensive Management will be offered sub-regionally. Level 3 is for members who have severe physical impairment from their pain as well as dysfunctional medication use and moderate to severe depression or anxiety. These members may require a case manager to coordinate their care. During the group intervention (80-90 hours over 2-3 months), all medical care, including prescription pain medication, is provided by the pain program physician. After the group program, the primary care provider resumes all patient care needs, with support from case manager calls to the patient and group appointments.
What is the expected program impact?
- Improve quality of life and ability to self-manage chronic pain for our members.
- Reduced emotional and psychological chronic pain symptoms via application of cognitive behavioral techniques and relaxation skills.
- More appropriate use of pain medications.
- Increased physical functioning.
- Reduced inappropriate utilization of primary and specialty care visits.
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