BOSTON, MA (October 26, 2017) – By thinking differently about pain management, healthcare providers may be able to solve the opioid crisis.

Providers who take a systematic approach to the kinds of drugs are used, when they’re used, and in what kinds of patients — and that draw on a wide range of medical disciplines, from primary care to neurology to psychology — can reduce drug use and pain care costs, while also helping ensure that patients experience less pain.

Utah’s Intermountain Healthcare collaborated with global management consulting firm L.E.K. Consulting to design such just a pain management program.

“We are working to reduce pain levels – and opioid doses – for new pain patients, while we improve pain levels and opioid doses for chronic pain patients,” said Bridget Shears, Intermountain Healthcare Director of Pain Management and Clinical Services. “Our view is that by providing more resources, a wider range of skills and a greater array of treatment options, we may be able to create a dynamic in which opioid escalation is no longer the reflexive ‘go-to’ treatment.”

Opioid addiction has reached crisis proportions

Opioid addiction and pain management are major challenges for the healthcare system.

Opioid overuse has reached crisis proportions. According to U.S. Centers for Disease Control (CDC) estimates, 80 lives are lost in the U.S. each day to overdose of pain medications like OxyContin.

And the high cost of pain care — dramatically higher than when patients are pain-free — is a threat to providers and insurers as well as patients. Pain can increase the cost of treating a given medical condition by up to 40 percent.

Pain must be addressed in every healthcare setting

The complexity of pain management makes it difficult to address.

“The challenge in pain management is that pain is a factor in every setting, from the primary care office to intensive care and everything in between,” said Bridget Shears of Intermountain. “For that reason, we have tried to draw on our entire system and create a collaboration among healthcare disciplines that could have an impact on every patient.”

“Our involvement has been to help Intermountain and take a systematic inventory of all their resources, then partner with them to match resources to needs” said Kevin Grabenstatter, Managing Director in L.E.K.’s Healthcare Services practice.

There are different goals and approaches for each setting and patient need:

  • Primary care: Primary care physicians — who often see pain patients first and who manage them long after acute care has finished — are given conservative alternatives to opioids and surgery. They get support from behavior health specialists, other clinicians, and outcomes data to design treatment programs that are less drug-focused.
  • Other outpatient settings: Specialized pain management clinics take the lead in treating chronic pain patients and those with complex problems. The clinics also serve as a resource for the rest of the system. The approach is multidisciplinary, including physical and occupational therapy, neurology, anesthesiology, and rehabilitation. Treatments address behavioral elements such as how patients perceive pain. The aim is to better manage complex pain, keep opioid doses from escalating, and stabilize patients so they can go back to primary care.
  • Hospitals: In the hospital setting, pain specialists serve as a resource. They work in the emergency room with acute surgical patients and support chronic pain patients who need to have their opioid doses lowered before surgery. Pain specialists aren’t common — recruiting and retaining them is a program focus.

Systematic pain management can bring costs under control

Cost reduction is another critical program goal. “Existing data shows that for patients with the same diagnosis, those with pain incurred nearly 40 percent higher costs per inpatient stay and nearly 20 percent higher costs per outpatient procedure,” Mr. Grabenstatter said. “That’s a compelling case for investing in and developing a comprehensive pain management strategy.”

“Programs like Intermountain’s are challenging to implement,” Mr. Grabenstatter said. “There are disparities in how pain management services are prioritized and paid for, at both the national and state level. Success will require a considered approach to align stakeholder interests and a thoughtful plan for tactical rollout.

“But the potential benefits are clear for individual patients, public health and the healthcare system as a whole,” Mr. Grabenstatter said.

About L.E.K. Consulting

L.E.K. Consulting is a global management consulting firm that uses deep industry expertise and rigorous analysis to help business leaders achieve practical results with real impact. We are uncompromising in our approach to helping clients consistently make better decisions, deliver improved business performance and create greater shareholder returns. The firm advises and supports global companies that are leaders in their industries — including the largest private and public sector organizations, private equity firms and emerging entrepreneurial businesses. Founded in 1983, L.E.K. employs more than 1,200 professionals across the Americas, Asia-Pacific and Europe. For more information, go to