Pain/Back pain designated medical spine

HealthPartners uses a comprehensive integrated approach to low back pain management that optimizes multiple care delivery components.

Aligned with ICSI's Low Back Pain guideline, we have identified an approach to networks and resources to support clinicians' efforts in caring for patients with acute and chronic low back pain.

Designated Medical Spine Centers:

are selected through a formal process and demonstrated expertise in spine care management that supports both primary and surgical clinicians that see patients that are potential surgical candidates.

Spine Surgery Resources:

provides helpful information on medical policy and administrative procedures for spine surgery office consult visits and procedures.


STEP 1: Primary Clinician

Recommends and coordinates a medical spine center visit.

STEP 2: Medical Spine Specialist

Completes comprehensive evaluation and recommends a treatment plan. A copy of this treatment plan will be sent to the primary clinician.

STEP 3: Spine Surgeon

If the patient continues on to see a Spine Surgeon for their lumbar back pain, the first office visit will require prior authorization. The spine surgeon's office will request a copy of the visit summary notes from the MSC to submit the PA.


Learn more about Back Pain

For general questions, please contact your contract manager or service specialist.
Considering sending your lumbar back pain patient to an orthopedic or neurosurgeon?

Follow these simple steps:

  1. Schedule a medical spine specialist evaluation, except in emergent conditions.
    • You can recommend an MSC from the listing under Practitioner Resources.
    • An MSC Patient Handout describing what to expect is under Handouts. Or
    • Direct your patient to call HPI member services number on the back of their card.
  2. After the medical spine visit, a copy of the evaluation will be sent to you. Your patient may decide whether to schedule the first spine surgery office visit. This decision is made by the patient and/or you regardless of the recommendation of the Medical Spine Center (MSC) specialist.

Practitioner Resources


For specific MSC geographic area:


Patient Education and Handouts

Improving Non-malignant Pain care: Opportunity & Resources

The Opportunity

  • Underutilization of clinical alternatives to prescription opioids have contributed to our national opioid epidemic.
  • Recent guidelines recommend physical therapy, weight loss, and cognitive behavioral therapy as safe alternatives to treat chronic pain.
  • Early physical therapy following a new primary care consultation for low back pain was associated with reduced risk of subsequent health care compared to delayed physical therapy.(Fritz, 2012)
  • Patient's receiving "early and adherent" physical therapy had 60% lower total low back pain related costs over 2-yrs.(Childs, 2015)
  • Twenty six states including Minnesota and Wisconsin have passed rules that allow patients to see a physical therapist on their own without having a referral from a physician.

Setting the Stage

Strategies for Improvement

Bio psychosocial Assessment

Best Practice Prescribing & Provider Resource Toolkit

Early Access to Alternatives

  • Consider a "First-line" physical therapy triage protocol for patients seeking initial care of pain.
  • #ChoosePT(The American Physical Therapy Association)

"Innovative" Process Improvement (2016-2017)

  • Consider strengthening your processes to support messaging around "good prognosis based on exam" and pre-planned structured education that reduces pain-related distress and enhances clinician-patient interaction. (Traeger, 2015)
  • Responsible Opioid Prescribing (COAT) - 2016 Essential Health Innovation
  • Comprehensive Opioid Response - 2016 Hazelden Betty Ford Foundations
  • Consider submitting your Innovative project to our 2017 Innovation Awards Program
Designated Medical Spine Center Network Providers

Medical Spine Centers are clinics with medical spine specialists certified in Physical Medicine and Rehabilitation, Occupational Medicine, Sports Medicine or Clinicians with advanced extensive training in spine care.

The Centers are committed to:

  • A biopsychosocial active reconditioning model
  • Evidence based practices as demonstrated by use of ICSI guidelines and written, evidence-driven protocols
  • Support primary care and surgical practices seeing low back pain patients that are potential surgical candidates
  • Support patients in choices for their treatment using a formal shared decision making process
  • Access standards
  • Multi-disciplinary care treatment method

Practitioner Resources
For a Quick Overview on the Approach:
Toolkit

Patient Education and Handouts

Designated Medical Spine Centers
For specific MSC geographic area:

Epidural Steroid Injection (ESI) Program Information

Effective July 2015, HealthPartners will require providers to utilize a decision support tool for Epidural Steroid Injections (ESI) ordered for the treatment of radicular lumbar pain. For more information, please visit the Epidural Steroid Injections Summary Page