Finding Solutions: Overcoming Chronic Low Back Pain

Article | February 2020

Finding Solutions: Overcoming Chronic Low Back Pain

Cigna is taking on pain management with the goal of reducing inappropriate opioid use.

Looking to help primary care providers (PCP) diagnose and more effectively treat patients with chronic low back pain, Cigna is taking on pain management while at the same time working to help reduce inappropriate opioid use.

“Many people experience low back pain during their lifetime, but there’s significant variability in practice patterns among PCPs and pain specialists when caring for customers with low back pain,” said Kim Wagner, R.N., clinical program development manager, Cigna.

Cigna’s Comprehensive Pain Management Program supports primary care providers with resources and tools to help them more effectively manage pain for patients with low back pain, while reducing inappropriate opioid use and clinical interventions that have limited proven benefit.

“Our program is designed to bring actionable data to physicians so they are empowered when it comes to treating chronic pain,” said Dr. David Mino, National Medical Director Orthopaedic Surgery and Spinal Disorders at Cigna.

The program integrates cognitive behavioral therapy, exercise therapy, pain management and pharmacology support for whole person health. It has been tested and implemented by provider groups that participate in Cigna Collaborative Care® Accountable Care programs in Arizona and Colorado and included more than 40,000 patients.

“We have seen an 8.2 percent decrease in opioid utilization1, which is really meaningful – and inspiring,” said Wagner. “In addition to a decrease in costs and opioid use, we also observed a decline in inpatient, emergency department and radiology utilization.”

Cigna’s program helps patients locate and use health care providers that align to these objectives including:

  • Pain specialists that more effectively manage pain using limited pain-injection interventions
  • Physical therapists with the goal of limited interventions and a shift to home exercise programs for self-maintenance and improved management of recurrent pain
  • Cognitive behavioral health specialists to address chronic pain and improve self-management of chronic or recurrent back pain.

“Health care providers who participated in the pilot expressed improved satisfaction with respect to the tools and resources provided to help people manage low back pain,” said Dr. Mino. “They have a clear evidence-based path, and developed workflows that help deliver better health outcomes and decrease the costs and risks related to a fragmented approach to managing back pain. Most importantly, we’re able to help patients get the care they need.”

 

physician with patient exercising

1Cigna medical data as of 2018, subject to change. Individual results will vary and are not guaranteed.