Chronic Low Back Pain
Disease Management (DM) Program

Preferred Care now offers a disease management (DM) program to help identified members manage chronic low back pain. The program offered through MVP Health Care, follows the Institute for Clinical Systems Improvement Adult Low Back Pain Guideline recommendations. In 2004 the program was named the best program of its kind in New York State in a statewide competition by the New York Health Plan Association (HPA).

Utilizing this DM Program will help improve and/or increase:

• the use of the conservative approach as the first line treatment, such as activity and self-care for patients with low back pain;
• behavior modification such as weight reduction, increasing the level and/or amount of exercise, and helping the member understand perceptions of disability;
• appropriate utilization of CT and MRI imaging of the sacrum; and
• appropriate use of pain management medications; and
• early intervention/referral to pain management programs, as appropriate.

At the same time, referring a patient to this DM Program will help decrease and/or reduce:

• extension of injury through work/activity modification and conditioning;
• the number of hospitalizations and ER visits for the defined population;
• the need for back surgery, as appropriate; and
• lost work time by working with physicians and employer groups. 

Program Components

Working in partnership with you, a team of health coaches – all registered nurses - provide education and health coaching to members by phone. Along with educational support materials delivered to members by mail, this program helps members make positive lifestyle changes and better control low back pain.

Health Coaching is a Key Component

Health coaching reinforces the care plan developed by the member’s health care providers. Talking with a health coach over the phone also empowers members to work on personal change and to utilize health care constructively. 

As health coaches, registered nurses assess the member’s stage of change related to each behavior that can affect the severity of back pain, such as smoking and obesity. Based on the member’s readiness to change, health coaches work with members to target specific behaviors and set improvement goals. Goal setting and charting progress toward achieving those goals, combined with a member’s scores on a health risk assessment survey, enable health coaches to tailor program information and support to each participating member.

For more information about this program or to refer a member for enrollment,

please call MVP health care at 1-888-357-4687.

Posted: October 5, 2007