A University of Pittsburgh (UPMC) Health Plan has mandated new guidelines for management for chronic low back pain. Starting in January 2012, candidates for spine surgery must receive “prior authorization to determine medical necessity”, which includes proof that the patient has “tried and failed” a 3-month conservative treatment plan which includes chiropractic care, physical therapy and medication.” These candidates must also complete the plan’s online health coaching program.
According to the UPMC’s Health Plan Update, they hope that this new initiative “will improve the quality of care for members who are considering low back surgery and help facilitate their involvement in the decision making process”. Most would agree that requiring members to try non-surgical and alternative therapies is a positive move in the direction of a more effective and multifaceted health care plan.
What a fresh and practical new policy! Gerard Clum, DC, a member of the Foundation for Chiropractic Progress, applauded UPMC for their “leadership in establishing new policies to assure that the least invasive and most likely to be successful care strategies, including chiropractic care will be applied…before surgical considerations are made”. He added that this decision is both “an important recognition of the value of chiropractic care for low back pain as well as the economic and clinical downfalls of spinal surgery.”
Covered chiropractic services include therapeutic exercises/rehab for building strength, endurance and flexibility of the affected area and manipulation (adjustments) to restore function that has been reduced by illness or injury. Our hope is that more companies will follow the lead of UPMC and begin adding policies.
This is great news for doctors and patients who already know & experience the many benefits of chiropractic care.
