Managed Care - June 2008 - (Page 49)

validated in the coming years as cervical pain syndromes become more extensively studied.6 STUDY DESIGN The CHP pilot project was designed as a prospective study to determine patient outcomes with respect to pain and function scores. All newly symptomatic patients from the CHP staff-model primary care practice were eligible for participation and became enrolled upon referral to the Orthopedic and Sports Physical Therapy practice. Financial and utilization outcomes of the study group compared to those who received usual referrals and care from other primary care practices will be extremely interesting and important to the health plan and will be the subject of future analysis. The project encountered incredible success early on, so five months into the project, access was expanded to CHP members seeking their primary care with Tallahassee Primary Care TABLE 1 Study results Quarter Visits per patient Average pain at entry Average pain at discharge Total improvement in pain score Percent pain improvement Average function at entry Average function at discharge Total improvement in function score Percent function improvement Percent with imaging prior to entry 3-month survey: Responses A Result B Result C Result 6-month survey: Responses A Result B Result C Result Associates, an independent primary care physician group not part of the CHP staff model practice. This provided an additional 15% of the total CHP population, such that 55% of the CHP population now had access to this pilot project during the final 7 months of the study. The outcomes from this pilot project have been excellent. During the course of the one-year pilot study, 171 patients enrolled in the program. These patients averaged 3.96 total visits to orthopedic and sports physical therapy. Pain and function scores were recorded by patient survey with a very simple scale. The patient was asked to report their level of pain from zero to 100, with 100 representing the worst pain possible. Patients rated their physical functioning on a scale from zero to 100, with 100 representing fully functional status with no deficits. Average pain scores improved from 53.65 to 11.32 and average function scores improved from 59.21 to 91.13. (See Table 1: Study results). Follow-up telephone surveys assessed whether the patient was experiencing an A (free of pain with no limitations or lost time at work), B (mild pain with no loss of function), or C (pain with limited function) result. Eighty-four patients participated in three-month surveys and the majority were distributed evenly with A and B results. Only four patients reported a C result. At six months, 39 patients participated in the surveys. Again these were evenly distributed with A and B results and only three patients reported a C result. EXPANDING THE STUDY Based on the outcomes in this pilot study, Capital Health Plan will give the entire plan population access to these physical therapy services. Additional expertise will be needed as this program expands to manage those who have experienced chronic pain. Chronic pain syndromes are somecontinued on page 54 Q1 3.60 51.46 8.33 43.13 83.81% 61.04 91.88 30.83 50.51% 58.33% Q2 4.53 56.25 11.94 44.31 78.77% 52.92 90.28 37.36 70.60% 72.22% Q3 3.38 53.94 12.66 41.28 76.53% 61.49 93.40 31.91 51.90% 59.57% Q4 4.55 53.63 12.75 40.88 76.22% 60.00 88.33 28.33 47.21% 50.00% Total 3.96 53.65 11.32 42.34 78.91% 59.21 91.13 31.92 53.91% 59.65% 35 19 14 2 20 10 10 0 29 14 13 2 84 43 37 4 30 15 12 3 8 3 5 0 1 1 39 19 17 3 JUNE 2008 / MANAGED CARE 49

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Managed Care - June 2008 Editor’s Memo Contents Viewpoint Letters News and Commentary Legislation & Regulation Medication Management Compensation Monitor Plans Chart Course in Rough Waters A Conversation With Barbara Starfield, MD Smoke Signals from Payers Slow Going for Clinical Decision Support Back Pain and Physical Therapy Formulary Files PlanWatch Outlook

Managed Care - June 2008

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