Back on Track: Understanding Pain Management in Oregon and California

By Mary Frances Ritchie, Research Associate

Policies that address opioid prescribing practices vary by state and often involve complex approaches for improving pain management for patients. The U.S. Department of Health and Human Services (HHS) “5-Point Strategy” wants to ensure better pain management, from payments to prescribing guidelines. As a Health Resources and Services Administration (HRSA) Health Center Controlled Network (HCCN), OCHIN prioritizes the study of chronic pain and opioid prescribing practices. The Back on Track Study aims to evaluate the impact of new Oregon Medicaid reimbursement guidelines for back and neck pain treatments.

In partnership with Kaiser Permanente and Harvard Medical School, OCHIN is pleased to be a part of this innovative and timely research study. This three-year study, funded by the Patient-Centered Outcomes Research Institute (PCORI), seeks to understand:

  • How Medicaid patients with back and neck pain in Oregon experience their pain compared to similar patients in California
  • How the Oregon Medicaid Payment rules change what services are available to patients
  • How health care providers and patients feel about the changes to coverage

The Back on Track study team will collaborate to review trends and outcomes in electronic health record data and other data sources, survey patients with back and neck pain at OCHIN clinics in Oregon and California, and interview patients, health providers, state-level administrators, and Oregon Coordinated Care Organizations as well as California Accountable Care Organizations. We hope that this multi-level evaluation will help inform the evidence base as well as emerging policies around pain management and opioid prescribing practices.

Engagement: The Back on Track study team regularly engages a diverse group of stakeholders who contribute to study activities. There are multiple engagement panels including a Patient and Caregiver Advisory Panel, Clinician Advisory Panel, Study Advisory Committee, and several national advisors. The engagement panels include patients, clinicians, and administrators from OCHIN membership, which makes this work invaluable to the Community Health Centers (CHCs) that we serve. Engagement is critical to patient-centered research and our stakeholders continually improve the implementation of our research practices.

Study Activities: We are actively working with several service areas, clinics, patients, and administrators in Oregon and California. If you are interested in having your service area participate in this study, recruitment will take place through August 2018. Please contact Perry Foley ( or Maura Pisciotta ( if you are interested in participating or have questions.