Improving your organization's spine care market share through
accountable and responsible business practice, sustainable process and patient centered excellence.
Spine pain is a $200 billion industry annually in the US with $90 billion in direct costs. Virtually every American citizen, regardless of socioeconomic status, race or age, can expect to suffer a painful low back condition during their life time with 80% recurrence rate.
Annually, the occurrence rate for a low back complaint among the United States population is 30%. It is the second most common reason people see their primary care physician and back pain patients incur 73% higher healthcare costs annually. Spine injuries are the leading cause of time lost from work and most costly industrial injury and accounts for 40% of all work related injury costs and in total.
The total cost for managing low back complaints rose in between the years 1997 – 2005. Total spine related costs rose from $20 billion in 1994 to over $90 billion in 2005 (includes direct costs). Indirect costs, those associated with disability/lost work time, rose similarly. This rise in cost did not parallel a rise in relative low back pain occurrence or severity and did not demonstrate substantial improvements in patient outcomes. In fact, during the period of 1997 – 2005 self reported functional limitations, mental health, work limitations and social limitations were worse among people with back related complaints. Finally, care standards for low back pain patients initially suggested by AHCPR in 1994 and again supported by Bone and Joint decade in 2008 went laregely ignored during this period.
Considering the related physical, social and financial costs, low back pain is more than a common complaint, it is a public health concern and burden.
As our population ages, individuals are searching for quality healthcare programs that they can count on in their community to keep them healthy well into their 80’s and beyond. The current market is defined by significant variability in care standards, cost of care and quality clinical outcomes. The market, in every community, is in need of a spine care pathway that serves the needs of the
- Community Hospitals: Need to provide community with quality and value added services and programs, establish synergies with physician groups while maintaining ROI. Need to prevent 'leakage' of patients out of your health care system.
- Community Patients: Demand patient centered care options, while burdened with higher co-pays and deductibles.
- Primary Care Groups: who are overburdened in a capitated / accountable care system, and challenged by effective and efficient strategies for managing spine pain patients
- Spine Care Specialists: burdened by decreasing reimbursement and cumbersome and encroaching utilization review
- Self insured groups, cities and municipalities: with devastating health care costs and rising claims
- Insurance companies with rising number of, and cost of, claims
- Federal and State regulators
Solutions to meet these needs must be practical for today’s environment and must be sustainable, addressing the social and political move toward accountable care organizations (ACO’s) and the patient centered medical home model of healthcare. Each of these constituencies has different interests and needs, but in aggregate is the demand for access to quality and affordable health care in that is accountable, sustainable and excellent.
Solutions to these complex social, political and economic concerns must be innovative, providing clinical excellence and ensuring financial success. Spine Care Partners has engineered a spine care program that, through quality process and strategy, can definitively meet each of these needs, incentivizing individual constituencies to utilize this service preferentially in your community.
This is accomplished through the coordinated application of two processes:
- Patient centered spine care pathway and algorithm: Defined through evidence based care measures that are universally applicable and transparent with built in quality assurance measures using lean six sigma principles. Patients are at the center of our program and their needs define the care they receive. Patients appreciate rapid, guaranteed access and lower costs. Our clinical process is tested and successful. Our model maintains engagement of all key stakeholders with minimal disruption of provider relationships. We specifically define provider roles, maximizing their time and resources, while bringing added efficiencies to spine care. Stakeholder buy-in ensures that 'leakage' of patients outside your health organization is reduced dramatically.
- Business model: Innovative, proven, cost effective and sustainable. The business model is defined by value, is measurable with simple implementation and reasonable start up costs. We seek to define our partners' current resources and identify gaps. Through process management, our model maximizes each provider's productivity. Each specialty is defined as a separate cost center, with a Spine Care Partners Spine Care Program defining the standard of care for the coordinated service.
Spine Care Partners will partner with your organization to create a program to meet your particular needs, define and brand your organization as the benchmark for quality spine care in your community, now and in the future.