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Spine & Neck Service Line Requires Planned Growth

Joe Cantlupe, for HealthLeaders Media, November 15, 2010
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Alvarado's Advanced Spine Institute includes a group of physicians who work in the hospital setting, with the facility providing machines for targeted back and neck maintenance programs. As Raiszadeh sees it, the physicians have different specialties, with one common goal: "to treat all aspects of the spine under one roof."

The SpineZone program evolved over time with a focus on strengthening the lumbar core musculature in a setting supervised by spine surgeons, Raiszadeh says. Research has shown that lumbar extension progressive resistance exercises significantly increase strength and decrease pain in patients.
A yearlong preliminary study that evaluated the conditioning of SpineZone patients in an HMO population from October 2007 through September 2009 found 40% in overall reduced costs in the treatment programs, including a 57% reduction in medication costs, compared to a control group.

The SpineZone patients were involved in an extensive three-month exercise and monitoring program, compared to other patients who received traditional therapies over a few weeks, says Raiszadeh. The 40% overall cost savings include savings in injections, surgery, consultations, therapy, and related matters, according to Raiszadeh. The HMO population was treated with standard physical therapy treatment through the primary treating physicians.

Both the study and control group patients suffered from greater than six weeks of pain that was not controlled by standard treatment. The SpineZone group underwent up to three months of targeted strengthening with initial and monthly visits with either orthopedic spine surgeons or physician assistants. The control group was treated with physical therapy, chiropractic, or pain management injections.

Generally, "a treatment protocol incorporating targeted strengthening with routine evaluation and follow-up by orthopedic spine surgeon or physician assistant can significantly decrease the overall cost of spinal care in a managed care population," the study notes.  The study was coordinated by SpineZone and Sharp Community Medical Group, which cares for 190,000 patients in San Diego, according to Raiszadeh.
The study showed the overall importance of minimally invasive procedures, and potential reduced costs as an outcome, says Raiszadeh. "When you look at the costs to the HMO—injection, surgery, treatment, cost of MRIs, and consultation—all those things, we are able to reduce the costs." Raiszadeh says the program is attracting interest from other insurance carriers. "We are doing a prospective study to assess patient outcomes and differentiate the outcomes of SpineZone patients from the standard treatment, but empirically patients' outcomes have improved," he says.

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