Jordan Hospital Article

Spine Care Partners founders, Dr Paskowski, Dr Ventura and Dr Justice have published an article about the first year of operation of the Jordan Hospital Spine Care Program. The article was published in the February 2011 issue of the Journal of Manipulative and Physiological Therapeutics.

A Hospital-Based Standardized Spine Care Pathway: Report of a multidisciplinary, evidence based process.            
I. Paskowski, DC, M. Schneider, DC, PhD, J. Stevens, DC, J.Ventura, DC, B. Justice, DC


Jordan Hospital implemented a multidimensional spine care pathway utilizing the NCQA Back Pain Recognition Program (BPRP) as its foundation.  The goal was to implement an evidence-based standardized process to improve clinical outcomes and reduce costs associated with treatment and diagnostic testing.

A standardized Spine Care Pathway (SCP) was developed to improve the quality of back pain care. The NCQA BPRP provided the framework for both the Spine Care Pathway and the valid metric to determine the level of quality care delivered. Patients were also triaged into one of six classifications based upon history and examination, Directional Exercise Flexion or Extension Biases, Spinal Manipulation, Traction, Spinal stabilization exercises, or Work conditioning.

This paper reports the findings for 518 consecutive patients. 116 patients were seen once and triaged to specialty care; 7% of patients received MRIs. 432 patients (83%) were classified and treated with chiropractic care and/or physical therapy. Results for the patients treated with chiropractic care were: mean of 5.2 visits; mean cost per case of $302; mean intake pain rating score of 6.2/10 with mean discharge score of 1.9/10; 95% of patients rated their care as ‘excellent’.

By adopting the NCQA BPRP as a spine care pathway, training physicians in this spine care pathway and utilizing a back pain classification, Jordan Hospital Spine Center was able to demonstrate the quality and value of care rendered to a population of patients. This was accomplished with relatively low cost and with high patient satisfaction.

Keywords: Low Back Pain, Healthcare Quality Assurance, Chiropractic, Physical Therapy


Spine Care Partner member Donald Murphy has published Clinical Reasoning in Spine Pain Lumbar Spine and Clinical Reasoning in Spine Pain Cervical Spine. 

Review of Clinical Reasoning in Spine Pain....................READ MORE


 MIPS of CMS   

The Center for Medicare and Medicaid Services (CMS) has established the Physician Quality Reporting System(PRQS) to improve the quality of care rendered to Medicare patients.Note: 2016 was the last program year for PQRS. PQRS transitioned to the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program. The final data submission timeframe for reporting 2016 PQRS quality data to avoid the 2018 PQRS downward payment adjustment was January through March 2017. The first MIPS performance period is January through December 2017.     For additional information about MIPS,,,,,,,,,,READ MORE


Accountable Care Organizations, or ACOs, appear to be the latest iteration of clinical care/reimbursement models seeking to increase the quality of care while managing the costs of care. According to Iglehart in the January 2011 issue of the New England Journal of Medicine, in 2005 CMS initiated a pilot project to evaluate 10 ACOs. Half were physician organizations integrated with hospital ownership directly  and the other 5 were affiliated with academic institutions or independent. The physician groups were charged with meeting certain quality metrics (process driven) and with meeting expenditure targets established prospectively. Those groups meeting the expenditure targets were paid a bonus of 80% of the savings to CMS. Curiously, none of the physician groups owned by hospitals were able to meet the expenditure targets. This CMS pilot project to test ACOs worked unilaterally though in that while physician groups meeting expenditure targets were paid a bonus, no physician group was financially penalized for not meeting the target.