Introduction
The Section 4305 of the Affordable Care Act was developed and implemented in order to improve pain management and ensure that the majority of current care models could be altered in line with patients’ and providers’ experiences. Knowing that different levels of care had to be considered, the policymaking bodies were free to experiment with care settings and the benefits that could be attained through the interface of improved pain management (Association of University Centers on Disabilities). Accordingly, the new sections in the Affordable Care Act (including the Section 4305) were all based on reimbursement innovations, care integration, and delivery methods. Thus, the Section 4305 was developed and implemented in an attempt to create a balanced relationship between care cost, effectiveness, and safety (Manchikanti et al., 2019). Service delivery became significantly more well-thought-out when providers and policymakers began advocating for high-quality pain management.
Background
The idea to introduce the Section 4305 became the most rational when care providers across the country recognized the need to reach cooperative agreements and find balance between public and private care provision entities. Without education and training, pain management initiatives were ineffective because care professionals could not approach patients uniquely (Manchikanti et al., 2019). Thus, it was important for care providers to recognize the opportunity of controlling the process of care provision and establishing an effective relationship with all types of patients. The Section 4305 became so important for the Affordable Care Act because it altered the way all applicable laws and policies were touching upon the ethics and socioeconomics of pain management (Institute of Medicine). The former misconceptions were reviewed in detail in order to see if there are still any barriers averting patients from communicating their key concerns about the quality of allegedly effective care they received.
Historical Context
From the point of the historical context of the Section 4305, the primary reason to include it in the Affordable Care Act was the need to recognize more public health problems. Invalid approaches to patient and provider education had to be removed from the care provision equation in order to help patients gain access to immediate assistance and alleviate pain when necessary (Le Blanc et al., 2020). Acute and chronic pains had to be approached differently because the community became increasingly diverse, appealing to the government in search of policies that would capitalize on their uniqueness. The former inadequacies had to be reduced through improved pain management and a stronger diagnosing capability. Thus, the existence of barriers to pain management was finally acknowledged on the level of legislation with the deployment of the Section 4305 (Interagency Pain Research Coordinating Committee). The private and public sectors were expected to act collaboratively to gain access to high-quality pain management.
Implementation: Preparation and Deployment
Throughout the first stage of policy deployment, the Section 4305 was thoroughly analyzed by the responsible bodies to achieve two particular objectives:
- Pain treatment had to be aligned against specific benefits and risks associated with care management processes. From various cost-effectiveness studies to clinical trials, there were numerous efforts exerted by policymakers in an attempt to combine existing solutions in an attempt to achieve a patient-centered care environment (Joyce et al., 2018). For instance, chronic pain management was considered one of the primary factors in the process, as pain therapies had to be customized in line with patient needs. The existence of various disparities had to be addressed by policymakers as well because they had to pay attention to financial incentives and their ultimate effectiveness.
- Pain care quality had to be evaluated with the aid of new policies. Due to the slow process of innovation in the field of care models, the Section 4305 had to be developed in order to address the barriers that averted care providers and patients from engaging in effective treatments. The lack of understanding represented a crucial obstacle that could not be overcome due to disparities in care provision (Association of University Centers on Disabilities). Consequently, the stigma linked to pain management could affect reimbursements and other clinical incentives connecting patients and providers.
Implementation: Public Opinion
The increasing burden of pain management also became one of the key reasons why the Section 4305 had finally appeared in the Affordable Care Act. The public appreciated the reviewed level of pain management effectiveness and became significantly more invested in the process of developing interventions associated with pain management (Institute of Medicine). The increasing number of disadvantaged individuals became the catalyst event that eventually caused the public to take a better look at the Section 4305 and ensure that the previous void in the field of care management would be filled by new preventative and facilitative interventions. Even though consumers were reluctant at first due to the inconsistent support, the participation in the process of clinical research significantly improved the relationship between care providers and patients (Interagency Pain Research Coordinating Committee). Nevertheless, an adequate analysis of cost-effectiveness of new policies had to be evaluated yet.
Implementation: Known Obstacles
There were three definite obstacles that affected the process of implementation and had a relatively negative impact on the Section 4305 upon deployment:
- Pain states were rather hard to determine and distinguish, making it harder for care providers to collect relevant data and organize it into categories. Responsiveness to treatments was hardly predicted before this policy because numerous biomarker features were left out due to negligence and insufficient research effectiveness.
- The lack of standardization and evaluation opportunities increased the size of datasets used to describe patient cohorts and address their health conditions. Basic research incentives were hardly translated into their clinic counterparts due to insufficient evidence regarding pain management and tracking.
- Data resources had to be expanded and leveraged in order for care providers to understand the limitations of their existing approaches to pain management. Therefore, unprecedented patient outcomes could transpire because of unstructured data and the lack of effective patient management.
Legal and Policy Challenges: Local
The core local challenge associated with the Section 4305 was the need to develop and deploy a population-level strategy to manage, treat, and prevent various pains. The lack of coordination efforts made it exceptionally complex for the local governments to develop research in the field and alter the existing agendas across the private and public sectors (Joyce et al., 2018). Another challenge for local bodies would be to cooperate with relevant committees while also contributing to the improvements associated with pain management programs. Ultimately, the task would be to enhance public awareness and make more patients interested in participating in the treatment process.
Legal and Policy Challenges: State
On the state level, there were three crucial challenges that could be associated with the deployment of the Section 4503:
- There were no care provider organizations established that would enable pain management improvements and raise awareness in the region. From self-management to more complex educational approaches, there had to be more culturally-based approaches that would help educate more patients and providers.
- The disproportions between different cohorts of patients were not scaled appropriately, leaving it up to local organizations to manage untreated pains and address pain management processes in general.
- The number of educational opportunities on the state level was rather limited, with the only facilities with access being professional associations. It also contributed to the lack of patient and provider education. Thus, larger pain assessment efforts could not be considered effective due to the absence of evidence on pain management.
Legal and Policy Challenges: Federal
As for the legal and policy challenges that affected the Section 4305 on the federal level, the core issue that can be outlined is the absence of consistent collaboration among professional organizations focusing on pain management. Even though joint efforts could significantly improve the quality of care, numerous organizations overlook proficiency for the sake of increased profit. This is where policymakers could benefit from generating referrals and altering reimbursement policies while looking at the evidence from the field. At the end of the day, it would pave the way for consistent pain assessment at the federal level that would be as complete and efficient as expected by both providers and patients.
Discussion Questions
Do you see the Affordable Care Act as an efficient care provision model when it comes down to pain management? Why?
With regard to the Section 4305, what do you believe is the most important value that has to be preserved by (a) state governments; (b) local care providers?
Summary of Key Points
The Affordable Care Act is one of the fundamental developments in the field of the US healthcare that was intended to improve the process of care provision as a whole. The Section 4305 represents a detailed review of how pain management could enhance the overall quality of American healthcare without putting too much of a burden on the country’s healthcare budget. Even though it seems to be a trivial task, the process of educating providers and patients became rather lengthy and resource-intensive. From the lack of standardization to the inability to manage the volumes of available data, numerous care providers across the whole country had to experience challenges linked to pain management.
Conclusion
Despite the initial uncertainty that has affected the Affordable Care Act and the Section 4305, the current state of pain management efforts shows that the government has found the right approach to informing the community about the importance of collaborating and researching. Even though not all initiatives are supported financially, the presence of improved pain management and prevention efforts shows that all actors recognize the importance of the problem. The deployment of the Section 4305 of the Affordable Care Act was an essential step forward that accelerated the discovery process and gave care providers a series of competitive advantages they could use. This strong inclination toward evidence-based solutions and data-driven decisions makes it safe to say that pain management and treatment have been enhanced significantly with the deployment of the Section 4305.
References
Association of University Centers on Disabilities. Patient Protection and Affordable Care Act Prevention and Wellness Provisions: Title IV [PDF]. Web.
Institute of Medicine. Relieving Pain in America A Blueprint for Transforming Prevention, Care, Education, and Research [PDF]. Web.
Interagency Pain Research Coordinating Committee. Federal Pain Research Strategy [PDF]. Web.
Joyce, C., Schneider, M., Stevans, J. M., & Beneciuk, J. M. (2018). Improving physical therapy pain care, quality, and cost through effectiveness-implementation research. Physical Therapy, 98(5), 447-456. Web.
Le Blanc, J. M., Heller, D. R., Friedrich, A., Lannin, D. R., & Park, T. S. (2020). Association of Medicaid expansion under the Affordable Care Act with breast cancer stage at diagnosis. JAMA Surgery, 155(8), 752-758. Web.
Manchikanti, L., Soin, A., Mann, D. P., Bakshi, S., Pampati, V., & Hirsch, J. A. (2019). Comparative analysis of utilization of epidural procedures in managing chronic pain in the Medicare population: Pre and post Affordable Care Act. Spine, 44(3), 220- 232. Web.