Avesta is pleased to announce that we are an Advocacy Consortium Clinic. What does that mean? It means we are participating in the mission to ensure access for pain and mental health patients to safe ketamine treatments through insurance coverage.
The Ketamine Taskforce Advocacy Clinic Consortium
Recently, on February 1, 2021, the national Ketamine Taskforce for Access to Safe Care and Insurance Coverage was officially launched. The Ketamine Taskforce was created with the intent to increase access to lifesaving ketamine treatments for those suffering from pain and mental health disorders. The Taskforce works by bringing together patients, doctors, nurse anesthetists, nurse practitioners and researchers from around the country to stand behind one common goal: insurance coverage for ketamine treatments.
We are proud to stand behind this mission because we fully support the evidence-based use of ketamine for the treatment of mood disorders and chronic pain. The goal of the Advocacy Consortium Clinic is evidence gathering. It is important for our patients to know that no data will ever be traceable back to a clinic or an individual patient and will never be shared between clinics. This is not a research study, but a real-world evidence consortium, in which anonymized and aggregated charts will be retrospectively analyzed to examine outcomes in naturalistic clinical care settings.
Strength in Numbers
The idea here is strength in numbers. The Ketamine Taskforce is an Advocacy Clinic Consortium-- which is essentially, “a network of clinics who are aligned in this mission and who plan to contribute aggregated, de-identified real-world data on the efficacy of ketamine for analysis and submission to the Centers for Medicare and Medicaid Services (CMS)."
Why the Advocacy Consortium Clinic matters
Currently, insurance organizations around the country typically consider the use of ketamine for pain and mental health “experimental” and therefore do not cover it in its entirety or at rates that are fair to ketamine providers. This has left the tens of millions of Americans experiencing mental health conditions and pain with huge suffering and lack of access to affordable treatments. This presents a huge obstacle to the majority of mental health and pain patients who are forced to forego this life changing treatment because they cannot afford to pay out of pocket.
Millions are suffering from chronic pain and mental health conditions
It is well documented that some 50 million Americans are estimated to experience chronic pain and 50 million are estimated to live with a mental health condition (with much overlap between the two populations). This is reason enough to provide adequate access to ketamine, especially considering the drug has several decades’ worth of demonstrated efficacy and safety.
In an effort to jumpstart the effort towards insurance coverage, the Taskforce’s first target indication is Complex Regional Pain Syndrome (CRPS), with mental health to come. The Ketamine Taskforce and Osmind are collecting real-world data through the Advocacy Clinic Consortium to prove that ketamine lowers patients’ pain levels and increases their mobility, and therefore leading to an increase in their active participation in activities of daily living and their overall quality of life. The outcomes from the consortium are very important and will be used to encourage Medicare to approve ketamine as a viable treatment alternative for CRPS patients. Furthermore, this effort will pave the way for coverage expansion into additional pain and mental health indications.
According to initial reports, the Taskforce has “already made progress on an application for adequate reimbursement coverage to CMS, who has requested real-world evidence to aid its diligence process.”
Final Thoughts
By participating in this effort, we are committed to ensuring access for pain and mental health patients to safe ketamine infusions through the approval of insurance companies to cover the infusions--and also provide a fair rate to ketamine providers for their time and work. If you have questions about Advocacy Consortium Clinic or want to learn more about participating contact ketaminetaskforce@gmail.com or feel free to ask us any questions.
