The Problem
- Each year, the prevalence rate/frequency of low back pain is 15-20% of the total US population.
- 25% of adults 18 or suffer from chronic joint pain.
- 95% of low back pain resolves within 6 weeks, through no care, aided self-care and/or non-invasive therapy (spinal manipulation, NSAIDs, ice, rest, etc.).
- 14% of insured low back pain patients are prescribed opioids.
- 38% of spine surgery patients never receive pre-operative PT or chiropractic care.
- Traditional go/no-go prior authorization programs fail to channel patients into the proper care modality.
The Solution
- A highly multi-functional team of care managers, data scientists, patient navigators, chiropractors, physical therapists and spine/orthopedic surgeons, dedicated to resolving joint and back issues through early identification, proper assessment coaching/encouragement and early assignment to the proper care path/treatment modality.
- A system which achieves early identification/assessment through data mining & application of AI/Machine learning.
- An integrated set of clinical resources and financial decision support tools.
- An integrated set of clinical resources and financial decision support tools.
- An approach which ensures provider collaboration, enhanced network access and provider performance management through sharing of detailed practice-level and individual performance data.
- Advanced technology and access to telemedicine which lowers systemic and per-patient cost and increases compliance to evidence-based clinical protocols.
Results
- Early identification of patients leads to better self-care and incidence of surgical interventions.
- Reduction in opioid prescription by PCP and specialist physicians.
- Site-of-care optimization saves money and hastens recovery for surgical patients.
- Lower frequency/incidence of invasive procedures.
- Less financial impact on family budgets through minimizing patient deductibles and copayments through site-of-care optimization, quality awards and better use of non-invasive treatment modalities.
- Fewer lost work days and better quality of life for patients and families.
