By encouraging people with low back pain to access physical
therapy or chiropractic care, the benefit design is expected to
reduce the number of imaging tests, spinal surgeries and opioid
prescriptions
UnitedHealthcare has introduced a new benefit for people with
acute low back pain that makes it more affordable to access
physical therapy and chiropractic care, helping to improve health
outcomes, reduce costs and avoid often unnecessary invasive
treatments and opioid prescriptions.
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the full release here:
https://www.businesswire.com/news/home/20191029005055/en/
Nearly 70% of people will experience low
back pain at least once during their lifetime, so considering these
tips may help prevent and treat this common condition. (Graphic:
Business Wire)
With this new benefit design, plan participants enrolled in
certain employer-sponsored health plans can pay $0 out of pocket
(waived deductible or copay) if they select physical therapy or
chiropractic care for the treatment of low back pain, helping
encourage people to choose these noninvasive options.*
Based on a UnitedHealthcare analysis, by 2021 this benefit
design has the potential to reduce the number of spinal imaging
tests by 22%, spinal surgeries by 21%, opioid use by 19%, and lower
the total cost of care for eligible plan participants and
employers.1
“This new benefit design may help encourage people with low back
pain to get the right care at the right time and in the right
setting, helping expand access to evidence-based and more
affordable treatments,” said Anne Docimo, M.D., UnitedHealthcare
chief medical officer. “With millions of Americans experiencing low
back pain currently or at some point during their lifetimes, we
believe this benefit design will help make a meaningful difference
by improving health outcomes while reducing costs.”
The benefit covers, at no additional out-of-pocket cost, three
physical therapy or chiropractic visits, along with additional
visits normally covered under the plan, to a qualified care
provider. This design helps make it more affordable for people with
low back pain to obtain treatment from the over 75,000
chiropractors and physical therapists participating in
UnitedHealthcare’s national care provider network.
The benefit design was informed by a recent study by OptumLabs
and the Boston University School of Public Health that showed
higher out-of-pocket costs made it less likely for patients with
low back pain to choose clinically recommended noninvasive
treatments, such as physical therapy and chiropractic care. For
example, people with a copay of more than $30 were 29% less likely
to see a physical therapist than patients whose copay was $0. There
was a similar correlation between deductible and choice of physical
therapy to treat low back pain, according to the study in The
American Journal of Managed Care.
Nearly 70% of people experience low back pain at least once in
their lifetime, and about one-quarter of adults in the United
States report experiencing the condition in the past three months.2
3 Despite clinical recommendations against it, opioids are
prescribed for nearly 9% of new low back pain cases, with this
condition ranking as the most common reason for an opioid
prescription.4
To treat low back pain, the American College of Physicians (ACP)
recommends exercise and the use of non-pharmacologic and
nonsurgical approaches including physical therapy, chiropractic
care, acupuncture and nonsteroidal anti-inflammatory drugs.5 These
noninvasive treatment options help 95% of people with low back pain
recover after 12 weeks.6 Muscle relaxants and imaging, such as an
X-ray or MRI, should be secondary options, and spinal surgery
should be a last resort. Opioids should be avoided.5 However,
certain "red-flag" symptoms, such as fever or loss of bladder and
bowel control, may require immediate testing and intervention.7
This new UnitedHealthcare benefit change is available now for
some new and renewing employers with fully insured plans and 51 or
more employees in Connecticut, Florida, Georgia, New York** and
North Carolina. Starting Jan.1, 2020, the benefit will be expanded
to new and renewing employers with self-funded plans and
organizations with two to 50 employees in the following states:
Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North
Carolina, South Carolina, Tennessee and Virginia. Broader expansion
is planned throughout 2020 and 2021.
Eligible employers with fully insured plans that include
coverage for physical therapy and chiropractic visits have this
benefit at no additional cost.
More information about strategies that may help treat low back
pain and this benefit is available here.
* Eligible plan participants must have remaining physical
therapy or chiropractic visits under their plan; the new benefit
design does not increase the maximum number of covered physical
therapy or chiropractic visits per year.
** Benefit design available to employers with more than 101
employees.
About UnitedHealthcare
UnitedHealthcare is dedicated to helping people live healthier
lives and making the health system work better for everyone by
simplifying the health care experience, meeting consumer health and
wellness needs, and sustaining trusted relationships with care
providers. In the United States, UnitedHealthcare offers the full
spectrum of health benefit programs for individuals, employers, and
Medicare and Medicaid beneficiaries, and contracts directly with
more than 1.3 million physicians and care professionals, and 6,500
hospitals and other care facilities nationwide. The company also
provides health benefits and delivers care to people through owned
and operated health care facilities in South America.
UnitedHealthcare is one of the businesses of UnitedHealth Group
(NYSE: UNH), a diversified health care company. For more
information, visit UnitedHealthcare at www.uhc.com or follow @UHC
on Twitter.
1 UnitedHealthcare modeling, 2019.
2 Kassebaum NJ, Arora M, Barber RM, et al. Global, regional, and
national disability-adjusted life-years (DALYs) for 315 diseases
and injuries and healthy life expectancy (HALE), 1990–2015: a
systematic analysis for the Global Burden of Disease Study 2015.
Lancet 2015;388:1603–1658.
3 Hoy D, March L, Brooks P, et al. The global burden of low back
pain: estimates from the Global Burden of Disease 2010 study. Ann
Rheum Dis. 2014; 73(6):968-74.
4 OptumLabs. 2018 Opioid KPI Metrics.
5 American College of Physician Guidelines. Noninvasive
Treatments for Acute, Subacute, and Chronic Low Back Pain: A
Clinical Practice Guideline from the American College of
Physicians.
http://annals.org/aim/fullarticle/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice.
April 4, 2017.
6 Cleveland Clinic. Chronic Back Pain.
https://my.clevelandclinic.org/health/diseases/16869-chronic-back-pain.
Accessed July 2019.
7 Harvard Medical School,
https://www.health.harvard.edu/pain/when-is-back-surgery-the-right-choice.add,
2014
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Will Shanley UnitedHealthcare (714) 204-8005
will.shanley@uhc.com
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