Reference no: EM132230174

Sally Campion, the manager of Vincent Valley Health’s ACO, has just completed a cost analysis of their members with lower back pain. Based on comparative data she felt her ACO’s costs were too high – especially for surgical services. However this was one of her first analysis projects that directly confronted practice variation. She was aware that many physicians on her medical staff had different clinical judgements on the most appropriate treatments for back pain. As a result she formed a team to do deeper analysis of her data and to examine all treatment options before she would begin a project to deliver the most cost effective, high quality care. Her team consisted of: Dr. Ira Moscone – Chief Medical Officer, Dr. Robert Munsey – Chief of Family Medicine, Phyllis Colson – Nursing director – Surgery, and Sameer Inanpudi – Director of Business Intelligence. Issues she felt needed research included

• What were well accepted guidelines from the US National Guideline Clearinghouse, Cochrane Institute, or peer reviewed articles in Pub Med?

• What alternatives were available for pain management outside of medications (e.g. alternative and functional medicine?)

• Could “shared decision making” play a role in any new therapeutic approaches?

• Would a pay for performance system be helpful within the VVH compensation system? What would you conclude as a recommended evidence based approach to improve lower back pain care at VVH?