November 8, 2023 by
Janet Essman Franz
Erin Bingham, N.P., guides Comprehensive Pain Program participants in yoga, meditation, and acupressure to relieve pain and improve function. (Photo: David Seaver)
In an important national first—one that can serve as a model for other states—Vermont Medicaid entered into a pilot program to provide its members with the ability to participate in integrative, holistic treatment for chronic pain. The Comprehensive Pain Program, a clinical arm of the Osher Center for Integrative Health at the University of Vermont, will serve up to 100 Medicaid members suffering from chronic pain through a program called Partners Aligned in Transformative Healing (PATH).
This initiative is an important step forward in eliminating disparities in access to effective, integrative care for chronic pain.
Cohorts of 10–12 participants, referred by their physicians, can access a range of integrative therapies including reiki, massage, culinary medicine, acupuncture, mindfulness meditation, and yoga, that are not traditionally covered by health insurance or Medicaid. In addition, participants engage in psychologically informed physical therapy, health coaching, nutrition, and occupational therapy.
Launched in 2019, PATH is a 16-week outpatient program that approaches chronic pain from a “whole person” perspective, melding conventional medical treatment with complementary therapies. The program has demonstrated success in improving participants’ level of comfort and their ability to engage in activities that are meaningful in optimizing their quality of life. By treating chronic pain holistically, PATH participants gain a variety of skills and techniques to manage symptoms, increase comfort, and improve function.
“The most common approaches to treat chronic pain are pills, injections, and surgeries. The Comprehensive Pain Program rose out of our awareness that our approach to working with the folks who have chronic pain was not necessarily effective in improving quality of life,” said Jon Porter, M.D., assistant professor of family medicine and medical director of the Comprehensive Pain Program, and director of UVM’s Osher Center for Integrative Health. “Our goal in the program is to widen the therapeutic horizon and give these individuals the tools they need to frame the experience of chronic pain, including therapies that can address their level of comfort, and engage in the things that are important to them.”
This Medicaid pilot is modeled after one pioneered by UVM Medical Center and Blue Cross Blue Shield of Vermont in 2019. Data from that program showed significant changes in key areas: Participants reported reduced pain, improved physical function, better sleep, and fewer visits to primary care and emergency care for pain relief.
“It’s been life-changing, ” said CPP participant John Killacky, who endured 27 years of debilitating chronic hip and leg pain before joining the program. “I do yoga, acupressure, acupuncture, reiki. To feel more whole, less broken, more filled with joy, is a very special gift.”
Access to this approach to care for Medicaid members is a first nationally. Medicaid was designed to provide a government-funded health insurance plan for income-eligible people and people who are categorically eligible due to their disabilities or socio-economic circumstances. Only a few comprehensive pain management programs incorporating integrative therapies currently exist in the United States, and their costs can easily put them out of reach for many people. Through this novel collaboration between the UVM Medical Center and the Department of Vermont Health Access (DVHA), which administers the Vermont Medicaid program, Medicaid members will have access to the full program of integrative pain therapies for one fixed price covered by insurance, rather than billing separately for each visit and service type.
Bringing the Comprehensive Pain Program’s whole-person, transprofessional, multidisciplinary approach to Medicaid members, who often experience barriers to care and fragmented care, is a huge step forward in health equity, says Porter. “A crucial component of the Osher Center's mission is working to eliminate disparities in access to care. Our agreement with DVHA is a tremendously important step forward in this direction,” he said.
Learn more about the Osher Center for Integrative Health at the University of Vermont.
Learn more about the Comprehensive Pain Program at UVM Medical Center.
Herbal treatments, acupuncture, and nutritious food can increase comfort and improve quality of life for people with chronic pain. (Photos: David Seaver)