Low Back Pain Quality Initiative

Low back pain affects up to 80 percent of Americans at some point in their life — with 50 percent experiencing more than one episode. Low back pain is the third most expensive disorder in terms of health care dollars spent, surpassed only by cancer and heart disease. It is also the most common and most expensive cause of work-related disability in the United States. Chronic back pain, defined as lasting longer than three months, is responsible for more than $50 billion a year in direct and indirect costs.

In response to these statistics, UPMC Health Plan recently introduced its Low Back Pain Quality Initiative, which was developed in collaboration with UPMC experts, chiropractors, and physical therapists. Algorithms developed for the program by a multidisciplinary group of providers will help guide decision-making for the early assessment and management of acute low back pain in UPMC Health Plan members.

Program goals are to:

• Proactively engage all UPMC Health Plan physicians, physical therapists, chiropractors, and members to work together to help patients (members) return to normal physical activities, significantly improve time to resolution of symptoms, and reduce avoidable admissions and recurrent and chronic low back pain.
  
• Reduce suffering from low back pain and the associated long-term disability, depression, and diminished quality of life.
  
• Implement evidence-based low back pain guidelines into clinical practice.
  
• Promote intervention within 72 hours after the onset, during the acute phase of low back pain before chronic symptoms develop, by encouraging an active provider approach to low back pain management.
  
• Increase the percentage of members with resolution of low back pain within two to four weeks of treatment by a physical therapist or chiropractor.
  
• Reduce the percentage of members with low back pain lasting more than six weeks.
  
• Reduce the prevalence of chronic back pain.

The Health Plan will achieve its goals through patient and physician education and through an online tracking tool that is accessible through Provider OnLine. The initiative will be led by the primary care physician in collaboration with physical therapists, chiropractors, and specialists. Outcomes from this database will be compiled and used to track the progress of the initiative. Individual patient information will only be shared with that individual by his or her provider.

We would like you to participate in this leading-edge initiative. If you have any questions about the Low Back Pain Quality Initiative, contact Provider Services at 1-888-876-2756.