Purpose: There are known disparities in chronic pain severity, treatment, and opioid-related risks amongst individuals from lower socioeconomic status, including Medicaid beneficiaries, but little is known about whether Medicaid beneficiaries benefit in a similar way from multidisciplinary chronic pain rehabilitation. This study investigated differences in clinical outcomes between Medicaid and non-Medicaid beneficiaries who completed a 3-week multidisciplinary chronic pain rehabilitation program.Methods: Participants (N = 131) completed a broad range of clinical measures pre- and post-treatment including pain severity, pain interference, depression, anxiety, objective physical functioning, and opioid misuse risk. Patients with Medicaid were compared with non-Medicaid patients in terms of baseline characteristics and rate of change, utilizing two-factor repeated measures analyses of variance.Results: There were baseline characteristic differences, with Medicaid beneficiaries being more likely to be African American, have higher rates of pain, worse physical functioning, and lower rates of opioid use. Despite baseline differences, both groups demonstrated significantly improved outcomes across all measures (p<.001) and no significant difference in rate of improvement.Conclusions: Results suggest that pain rehabilitation is as effective for Medicaid recipients as non-Medicaid recipients. Patients with Medicaid are particularly vulnerable to disparities in treatment, so efforts to expand access to multidisciplinary pain treatments are warranted.
Keywords: Chronic pain; clinical rehabilitation; health disparities; pain rehabilitation; socioeconomic status.
Medicaid beneficiaries, who tend to be from lower socioeconomic status (SES), with chronic pain have poorer baseline functioning compared to non-Medicaid beneficiaries, including worse pain severity, poorer physical functioning, and higher levels of anxiety.Medicaid beneficiaries appear to benefit significantly and in a similar way to non-Medicaid individuals from participating in multidisciplinary, non-pharmacological chronic pain rehabilitation.Expanding access to evidence-based chronic pain rehabilitation, including nonopioid and multidisciplinary treatments, is a key component to address the chronic pain and opioid crises that differentially impact individuals from lower SES.