Pain Management and Palliative Care in the Era of Managed Care: Issues for Health Insurers
Posted: 5 Jan 1999
This article reviews the literature regarding pain management and insurance coverage and reports on the results of an empirical study of medical directors at Blue Cross Blue Shield Plans across the country. The study attempted to assess the directors' awareness of pain management and palliative care as issues for their insured populations and to discover how their plans are dealing with various aspects of the problem. Medical directors at 64% of Blue Cross Blue Shield Plans were interviewed. Significant survey findings included the following: 1) plans deal with pain treatment and coverage/payment issues on a case by case basis (often through case managers) and, for the most part, have not established uniform pain treatment or coverage guidelines; 2) treatment of patients with chronic pain is of concern to more plans than treatment of pain for terminally ill patients; 3) plans are uncertain about who is a qualified pain care provider and how to evaluate the quality of pain centers; 4) a significant number of plans expressed concerns about fraud or inappropriate treatment by pain providers.
JEL Classification: I11
Suggested Citation: Suggested Citation