One of the largest causes for lost workdays in America is back pain. Its such an issue that plan sponsors and employers of all sizes have been looking at how best to help employees with these problems.
This month, the Pacific Business Group on Health announced an expansion of its Employers Centers of Excellence Network to include spine surgery.
The ECEN was created by large employers to facilitate the care and treatment of certain problems (like spine or knee and hip replacement issues) by bundling rates for different types of care through approved health facilities at no cost to the employee.
The ECEN is voluntary and patients can still choose to receive care from local providers and incur routine costs.
We initially sat down with eight employers to see how this type of program could meet the needs of different companies, says Olivia Ross, associate director of the PBGH. Also PBGH acts as a coordinator for a multi-employer collaborative using that same strategy of Centers of Excellence.
We vigorously evaluated the participating hospitals experience in evidence-based medicine and use of consistently applied patient appropriateness criteria to ensure that participating employees are receiving higher quality care, says David Lansky, president and CEO of the Pacific Business Group on Health.
The three hospital providers participating in the new spine care program include Geisinger Medical Center in Danville, Pennsylvania; Mercy Hospital in Springfield, Missouri; and Virginia Mason Medical Center in Seattle.
Employers, by becoming part of the ECEN and signing contracts (whether bundled or not), are given access to those evaluated hospitals making their due diligence process and costs faster and cheaper which is passed on to the employee.
We negotiate very competitive rates. We are also doing some early analysis on joints and the early results are looking good, adds Ross.
In-person assessments are also done by PBGH to ensure there is a fit between the goals of the member employers and the services of the healthcare providers.
Monthly calls take place to ensure best practices are shared amongst providers as well as educating one another on particular problems or issues that might come up.
Ross says that patients are encouraged to go to the ECENs because oftentimes patients are told they need surgery when they may not. Every patient has the option of in-person evaluation even if they are not a strong surgical candidate. By offering an in person evaluation at a center of excellence, all of our patients receive a comprehensive assessment from a team of experts that works with them to create an optimal, customized treatment plan.
Overall, employers and employees can have access to quality health care as pre-determined by PBGH research and ensure consultation and, if needed, eventual surgery.
The savings of due diligence, costs and administrative efforts is ultimately handled on behalf of the employer to provide the best hip and knee, and now spinal surgical options for their particular needs.
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