Dr. Mino is a fellowship-trained spine surgeon and a member of the North American Spine Society and American Academy of Orthopaedic Surgeons. He practiced spien care and surgery for 17 years.
Q: What was the impetus for developing this spine care program?
Dr. David Mino: The state of Wyoming, which is a Cigna client, has one of the highest rates of spine and back pain problems nationally. This was confirmed by Cigna data as well as a third party. The state of Wyoming expressed interest in developing a program for improving spine health and care. Some of the procedure costs were on the high end as well.
Q: How was the program developed?
DM: We wanted to figure out how to give the people of Wyoming the best care possible for back pain while also lowering the cost of care. Initially we met with our clients for the state of Wyoming and then sat down locally with the leadership at the medical center in Casper to discuss the program. We worked for a while putting together our thoughts, looking at the literature and studying the needs of our customers in the area. We acquired evidence based guidelines.
It was a very collaborative approach to providing the early access for appropriate care within one business day. This includes physician evaluations, physical therapy, education and self management for patients with individual back pain. Another key component of the program was minimizing work time loss.
Q: Who manages the program and directs patients when they enter?
DM: There is a clinic we've set up specifically in Casper that is managed by a physiatrist who is the gatekeeper. He promoted education of the program within the community. We also work with primary care physicians, rehabilitation staff and others in the local community to disseminate the program. We want to work with primary care physicians and help them provide the typical care to their patients.
Q: What unique aspects of the program have made it successful?
DM: This program only began this past year and so far we are hearing good feedback. It's a very customer-centric program which focuses on patient satisfaction. That has been a key metric of the program, along with developing an interdisciplinary approach to care. We are able to feed data back into the program as well.
One of the key areas we are looking at is early identification of individuals experiencing back pain and experiencing psychological or social issues that might be contributing to the back pain. This program includes the support of local psychologists in Casper and Cigna also brings services to the table, like pain management and conditioning support programs. There is an emphasis to really enhance care decision making for our customers. In coordination of those services through the gate keeper physiatrist we are able to provide effective management and direction for our customers.
Those who have gone through the program show very high satisfaction and at the end they have not returned for further care; they continue managing on their own. Thus far we have been primarily seeing individuals with acute back pain and typically they are seen by the physical therapist for three or four visits and the physiatrist for one or two.
Q: How does the program cut costs while maintaining quality of care?
DM: The focus of the program is to provide the right care at the right place at the right time with the right provider. The program is based on following evidence-based guidelines. Early physical therapy intervention provides education and management techniques while avoiding unnecessary costs including emergency room visits and advanced imaging, when those may not be able to accurately manage the condition.
We are trying to avoid over dependency on the healthcare system for back pain, which would include multiple medications and non-evidence based interventions. It's really about having the customer seen in the right place at the right time.
Q: Where do you see the program headed in the future?
DM: The early success of the program is really creating interest with other Cigna clients and employers to develop a similar program for their employees. There is also interest from other provider groups that really see the benefit and value of a coordinated and collaborative spine program for their patients and our customers.
More Articles on Spine Care:
The Future of Spine Innovation: Q&A With Dr. Hyun Bae of Cedars-Sinai Medical Center
5 Steps for Spine Surgeons to Resolve Liability Insurance Before Hospital Employment
5 Proactive Steps for Spine Surgeons to Influence Spine Care Policy
Lowering Spine Care Costs in Wyoming: Q&A With Cigna's Dr. David Mino FeaturedWritten by Laura Dyrda | Thursday, 24 January 2013 20:25
Cigna HealthCare has partnered with Wyoming Neuroscience and Spine and Elkhorn Rehabilitation Hospital in Casper, Wyo., to create a program that increases quality and lowers cost for patients in the area: Pathway to Improved Health for Back Pain. The State of Wyoming is among the highest spenders when it comes to spine and back pain, and related claims which nearly doubled from 2007 to 2009. Here, David E. Mino, MD, MBA, Cigna HealthCare National Medical Director, Orthopedic Surgery and spinal disorders, discusses the program and where it's headed in the future.
© Copyright ASC COMMUNICATIONS 2017. Interested in LINKING to or REPRINTING this content? View our policies here.
Top 40 Articles from the Past 6 Months
- Understanding the Impact of the CMS 2017 ASC Payment Rule on Spine Procedures
- 15 spine surgeons discuss techniques revolutionizing spine care
- What not to wear — Physician's attire elicits mixed responses in outpatient orthopedic centers
- Dr. Robert Watkins performs spine surgery on Patriots' Rob Gronkowski
- Behind bars for fraud: Neurosurgeon Dr. Aria Sabit receives nearly 20-year prison sentence — 8 key insights
- 6 spine physicians ranked #1 on Google - 2016
- 7 trends in healthcare digital transformation
- 9 Mayo Clinic strategies to quench the physician burnout flame
- 36 woman physician leaders to know
- Seattle Times examines Swedish-Cherry Hill's neuroscience program balance of volume & quality
- Rochester Regional Health in NY acquires Finger Lakes Bone & Joint Center: 5 key notes
- 4 spine surgeons caught in fraud — Prisoners, probationers & a fugitive
- Guilty verdict for neurosurgeon Dr. Christopher Duntsch for causing 'injury to an elderly person' — 5 things to know
- 26 latest statistics & notes on neurosurgeon salary — Hourly, annual & regional pay
- A review of 7 spine device company powerhouses in 2016
- Best & worst patient outcomes — Patients may now compare US surgeons by name
- Why the direct anterior approach for THA is the future
- Spine care in 2017: 4 spine surgeons make predictions
- Google Glass, GoPro or Panasonic HX-A100: Which is best during spine surgery? 5 key notes
- Five trends that every orthopedic professional should watch in 2017
- Swedish-Cherry Hill neuroscience chair Dr. Johnny Delashaw steps down amid investigation — 5 things to know
- What Stryker CEO Kevin Lobo said on CNBC: 7 key quotes on healthcare, business & the future
- Medtronic plans to sell medical supplies unit, Bloomberg reports: 6 key insights
- What 6 sports medicine physicians wish they would've known at the beginning of their careers
- American College of Physicians releases new guidelines for treating low back pain: 5 key points
- 16 things to know about spinal fusions
- 40 statistics on spine surgeon and neurosurgeon pay
- Dr. Kenneth Pettine: Stem cell therapy is here to stay
- Dr. Christopher Duntsch sentenced to life in prison for injuring his patients: 5 key takeaways
- Titan Spine leads push for titanium interbody device resurgence through nanotechnology differentiation
- How 10 spine surgeons are preparing their practice for a Donald Trump presidency
- 5 reasons why spine care will boom in the next decade
- The man behind the fraud — Who is Dr. Aria Sabit?
- 10 things to know about Stryker
- 5 health IT predictions for 2017
- Rothman Institute, Thomas Jefferson University & Jefferson Health open concierge spine center of excellence
- Drs. Frederick Boop, Michael Gleiber, F. Todd Wetzel & more: 90+ spine surgeons & neurosurgeons receiving honors in 2016
- DePuy Synthes earns FDA clearance for VIPER, EXPEDIUM screws: 5 highlights
- Henry Ford Health System drops out of Medicare bundled payments for joint replacement: 5 key notes
- 11 spine surgeons on advising their patients about experimental therapies