Chronic Pain Program Collaboration between Blue Cross and UVM Medical Center Outcomes Recognized
Unique payer and provider program design benefits patients through pain management
Berlin, Vermont—A recently published case study by researchers at the Duke Margolis Center for Health Policy focused on the positive outcomes for Blue Cross members participating in an innovative program to improve treatment options for patients struggling with opioid use for musculoskeletal pain conditions.
The study: Exemplary Integrated Pain Management Programs: University of Vermont Medical Center Comprehensive Pain Program examined the Partners Aligned in Transformative Healing (PATH) program at UVM Medical Center’s Comprehensive Pain Program (CPP), an intensive outpatient program that includes an array of integrative therapies. Through a partnership with Blue Cross and Blue Shield Vermont (Blue Cross), the program is supported by bundled payments that allow members to access a variety of services to address chronic pain for a fixed price to the hospital and limited personal expense for the patient.
The program has yielded quantifiable results in patient well-being, lower health care costs and utilization, and reduced Emergency Department visits for participants.
“Chronic pain can be debilitating, and providers are challenged with navigating pain management with a keen awareness of opioid dangers,” says Dr. Joshua Plavin, Vice President and Chief Medical Officer at Blue Cross as well as a practicing physician of Pediatric Internal Medicine. “This is an innovative partnership that supports patient-centered, value-based care.”
During the COVID pandemic, PATH was expanded from an 8-week to a 13-week treatment schedule that is delivered in small cohorts of 10-12 patients who participate in both group and individual programs. The integrated care team includes a host of providers. Physicians, nurses, and nurse practitioners address the whole patient. Psychiatrists, psychologists and social workers are available to address the mind-to-body connection. Psychologically-informed physical therapists, occupational therapists, massage therapists and movement specialists work with the patient to develop ways to move and rest differently. Acupuncturists and Reiki practitioners consider how to direct the body’s energy in different ways, while clinical dieticians and chef educators teach participants to plan and prepare healthy foods. This broad array of providers works together in a dedicated center that enables interaction and collaboration with the patients in the program.
A novel bundled payment arrangement with Blue Cross covers services that are not traditionally offered in commercial or public insurance expands the scope of treatment options, allows provider flexibility, and limits the patient’s financial burden.
“The PATH program is a glimpse into the future of health care,” says Dr. Jon Porter, MD Medical Director at the Comprehensive Pain Program. “While there were many hurdles to overcome, the program shows how successful these collaborations can be where holistic patient well-being is at the center, and providers and payers work together toward innovative solutions in care. We hope to expand the scope of this type of partnership.”
Chronic pain is complex, and providers have seen that medication can only help so much over time. The PATH program offers a toolkit that patients can use long-term to maintain a higher quality of life.
“This approach is emblematic of the type of health care reform projects that Blue Cross strives to implement in Vermont,” says Don George, President and CEO of Blue Cross. “The value-based payment structure and care delivery system changes must go hand-in-hand to enable improved care outcomes and cost savings so that both patients and providers may realize the benefits.”
Blue Cross and Blue Shield of Vermont is Vermont’s only local, not-for-profit health plan. For over 30 years, the company has been enhancing the health and well-being of the Vermonters by offering innovative plans to individuals, seniors and businesses. Our employees are dedicated to developing new ways to support high quality care and programs and events that promote health and wellness. Blue Cross and Blue Shield of Vermont is an independent licensee of the Blue Cross and Blue Shield Association. For more information, visit www.bcbsvt.com.