New disease management initiative in Colorado aims to treat low back pain and improve patient outcomes

HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that by increasing the role of the primary-care physician, the recently launched Colorado Low Back Collaborative (CLBC) aims to treat lower back issues with a more holistic view, and ultimately improve patient outcomes while lowering costs associated with the care of low back pain.

According to the new Colorado & Nevada Health Plan Analysis, the collaborative, which includes two insurers -- Anthem Blue Cross and Blue Shield of Colorado and UnitedHealthcare -- is the latest example of insurers joining forces to improve patient outcomes, and will require physicians to operate in a new direction when treating patients with low back pain.

The collaborative, a pilot that will run 18 months, also involves Exempla Lutheran Medical Center and its physicians, the Colorado PPO, and will engage approximately 500 patients and 35 primary-care physicians. Rather than move patients with low back pain from a primary-care physician to a specialist, the collaborative focuses on resolving patient issues in the primary-care setting, following evidence-based protocols that suggest more therapy driven by the primary-care physician will provide better outcomes for most patients than if they opted for surgery. For instance, prior to discussing surgery, a patient will be referred to a physical therapist, massage therapist or acupuncturist to find a nonsurgical solution.

"Physicians participating in this pilot in Colorado are being asked to change their practice style, and manage a patient's low back pain care more directly, instead of sending them to a specialist. This concept is in-line with the medical home model we are seeing roll out across the country, which relies on a team-based approach where the primary-care physician is providing coordinated care," said Bill Melville, analyst with HealthLeaders-InterStudy. "This is among the first disease management initiatives we've seen dedicated to low back pain. Given the widespread nature of this condition, the outcomes of this pilot will likely be closely watched. However, the organization took three years to come together and with two insurers and multiple organizations involved in this initiative, its transferability may be an uphill challenge."

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