CareCore National Expands Musculoskeletal Management Program

Today, CareCore National announced it is expanding its Musculoskeletal Management Program to help insurers and physicians more efficiently and effectively manage patient care through standardized treatment pathways.

The program recognizes that, while many board certified physicians currently treat various forms of pain, some physicians have more appropriate experience with specific types of cases. CareCore’s program aims to match the individual patient’s needs with the healthcare professionals most qualified to provide needed treatment.

“Credentials alone are not adequate to identify the most appropriate medical practices to help a patient in pain,” said Dr. Bartley Bryt, Executive Vice President, Clinical Director, Specialty Products at CareCore National. “Our mission is to help patients find the most appropriate and experienced practitioners to treat their unique situations. This provides more effective healthcare for the patient and the payer.”

Since 2009, CareCore’s Musculoskeletal Management Program has focused on interventional pain and currently protects 1.8 million lives. The expanded service will assist in the management of chronic pain associated with spinal and other issues.

While primary care office visits for back pain have remained steady, the U.S. Department of Health and Human Services (HHS) has found spiraling use of more aggressive therapies, including spine joint injections and spinal epidural injections to control pain, which increased 76 percent and 130 percent, respectively, over a three-year period.

CareCore National data also show costs of operating room services and implants to treat chronic pain are rising dramatically – spiraling from 40 percent to 75 percent a year, depending on the region of the country.

“Though the number of procedures is rising dramatically, studies show that 15 percent to 20 percent of spinal surgeries are unnecessary and can, in fact, cause more problems than they solve,” said Dr. Bryt. “Our approach to managing musculoskeletal and pain treatment plans ensures that patients receive the most appropriate therapies for their specific medical histories, based on data about treatments that work. We make sure the patient ultimately receives the right treatment at the right place at the right time. And we discourage non-essential procedures.”

“We also insist that patients actively participate in their treatments,” he said. “The treatment of chronic pain often requires patients to adjust their lifestyles, which often requires them to do specific exercises, lose weight or change their habits. Without a patient’s active participation, most treatments are likely to have less than optimal benefit and we are focused on helping our clients provide real solutions to medical problems.”

The coordination of care and treatment management can be challenging since chronic pain patients are cared for by diverse providers, ranging from primary care physicians to specialists, and treatments can include a broad range of therapies, ranging from self-care and alternative medicine to chiropractic care, physical therapy, and percutaneous and surgical interventions.