GHS, S.C. BlueCross tackling back pain

STAFF REPORTS
Published on Tuesday, January 24, 2012

Greenville Hospital System University Medical Center (GHS) is piloting a program to provide faster, more effective relief for employees’ aching backs. The Back and Neck Pain Program is part of collaboration between GHS and BlueCross BlueShield of South Carolina — and it could become the gold standard for BlueCross members who suffer from back and neck pain.

The pilot program is part of the hospital system’s Total Health program and aims to streamline what can be a complicated, uncoordinated search for solutions and pain relief. Patients often face a fragmented and costly process involving tests, pain medications, exercises, rehab regimens and surgery. The goal is to offer them treatment options swiftly, customized to their diagnosis and monitored for progress.

Patients will receive a rapid diagnosis at participating GHS physician practices. Instead of waiting days or weeks for the next step, they will start on a treatment “track” that same day. The various track options will be customized to match a patient’s diagnosis. All tracks will be based on national best practices and standards — treatments that experts recommend as effective. The quality of care will be closely monitored, as will patient satisfaction and overall costs. 

As an incentive for members, deductibles are waived for patients participating in the pilot program. BlueCross, as the administrator of the hospital system’s employee health plan, is designing a reimbursement process for the program and is helping to develop a program to measure outcomes and satisfaction.

“We anticipate that our employees and their dependents will have better outcomes, higher satisfaction and lower overall costs because of this new approach,” said GHS Chief Medical Officer Dr. Angelo Sinopoli. “It’s a coordinated approach to care in which our employees will experience less functional loss and disability.”

 “This is one of many BlueCross initiatives to collaborate with physicians, hospitals and our customers to achieve the Triple Aim of improved outcomes, reduced cost and enhanced patient experience,” said Dr. Laura Long, BlueCross’ vice president of clinical quality and health management. “GHS’ program is a comprehensive approach that allows the right level of care at the right time. If it is successful, we’ll look at offering it to our group accounts.”

Chronic low back pain affects up to 80 percent of Americans at some point in their lives. It’s the most common and most expensive cause of work-related disability in the United States, second only to the common cold as a cause of lost workdays. The third most expensive disorder in terms of health care dollars spent, it accounts for more than $50 billion a year in expenditures by health plans and in business costs due to absenteeism and lost productivity.

Of GHS’ group health plan, which includes 18,699 employees and dependents, more than 1,600 have had claims related to back or neck treatment in the past year.

 

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John Mansure

Businesses mentioned in this article.

Greer Memorial Hospital

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