DJO Global, Inc., a global provider of medical device solutions for musculoskeletal health, vascular health and pain management, today released an independent, estimated financial impact on Medicare patients who suffer from chronic low back pain (CLBP). The financial impact calculation estimates that using the current standard of care procedures to treat approximately 1.5 million Medicare beneficiaries who have chronic low back pain and seek medical intervention now costs approximately $1.3 billion annually. If all of those patients are supplied with a transcutaneous electrical nerve stimulation system (TENS), in place of other treatment options, Medicare could save an estimated $417 million. (See table) The research supports DJO Global’s Motion is Medicine initiative, a first-of-its-kind effort to help patients restore lost motion, maintain activity levels and improve overall health. The initiative addresses four areas: pain, alignment, strength and stability. After the onset of a chronic pain condition such as osteoarthritis or chronic low back pain, a patient is often inactive, which can lead to weight gain, health decline and major medical problems down the road. Using conservative care options that promote a patient’s ability to move can decrease hypertension, BMI, blood pressure, and a host of other complications and readmissions. Furthermore, motion and conservative care promotes patient engagement in wellness and helps control costs for specific bundled payments for healthcare providers.
“Physicians and hospitals continue to focus on controlling costs, enhancing the patient experience and improving the overall health of the communities they serve. Many clinicians have initiated a conservative care treatment option instead of surgery for their patients. They have experienced the value of including TENS as part of their standardized protocols. Pain management is a critical part of the patient experience and surgeons are looking for alternatives to narcotics and anti-inflammatory medications,” said Sharon Wolfington, President of Global Recovery Sciences, DJO Global. “Our Motion is Medicine initiative supports standardized conservative care treatments, such as TENS, that will help healthcare providers expand protocol management models to meet new requirements. We acknowledge that there will always be patients who require surgery and physical therapy for an optimal outcome and more follow up research and data analysis is required to present ongoing expanded clinical evidence in support of conservative care options.” The cost figures were calculated based on a recently published study in volume 36, issue 12 of , which looked at the clinical and economic impact of TENS in patients with chronic low back pain. The study evaluated patients who were given TENS compared with a statistically matched group without TENS for one year prior to intervention and for one year of follow-up. Patients who were treated with TENS had significantly fewer hospital and clinic visits, used less diagnostic imaging, had fewer physical therapy visits, and required less back surgery than patients receiving other treatment modalities. Furthermore, TENS is non-invasive and non-narcotic, so it does not have the risks associated with other treatment approaches.
The Affordable Care Act mandated new guidelines that reward and penalize healthcare providers for meeting certain benchmark levels of care. New legislation unveiled by Senate and House committees in early February 2014 introduced a new payment system that rewards physicians based on the quality of care provided rather than the quantity.1 Furthermore, Centers for Medicare & Medicaid Services (CMS) continues to build upon efforts to curb unnecessary treatments by assessing the appropriateness of certain cardiac and orthopedic procedures. Florida, one of eleven states included in the Recovery Audit Prepayment Review initiative, includes back and neck procedures, spinal fusion and major joint replacement as services needing review to ensure medical necessity before providers are reimbursed.2 “Although most payors continue to pressure doctors to utilize more conservative care options, CMS decided in June 2012 to remove reimbursement for TENS as a treatment for chronic lower back pain,” said Michael Minshall, Senior Director of Health Economics & Reimbursement, DJO Global. “Medicare still has to treat and pay for those suffering from chronic low back pain and may be overspending to achieve what is arguably poorer clinical outcomes that do not always relieve pain and discomfort.” DJO Global will be presenting this cost illustration and findings from the TENS clinical study at AAOS 2014. Session 466-480 is on Thursday, March 13, from 10:30am-12:30pm CDT in room #345 at the Morial Convention Center in New Orleans. Additionally, company representatives will be available at booth #1349 in the exhibition hall.
1 Hill Plan Would Reward Medicare Doctors For Quality: Kaiser Health News. (2014, February 7). Retrieved February 10, 2014, from http://www.kaiserhealthnews.org.
2 Medicare Audits 101: AAOS.org. Retrieved February 25, 2014, from http://www.aaos.org/govern/federal/Medicare/Medicare_Audits_101.asp