Identifying best practices: Area employers to target neck and back pain to trim health costs

by Dorothy Atkins, Aspen Daily News Staff Writer

A group consisting of the Aspen area’s largest employers is hoping to bring health care costs down by sharing information and identifying best treatment practices, and is starting with an in-depth look at neck and back issues.

The new Aspen Valley Health Alliance is a pilot program that includes Pitkin County, the city of Aspen, Aspen Valley Hospital (AVH), Aspen Skiing Co. and the Aspen School District, which together insure thousands of people in the valley. Each organization expects their health care costs to increase about 7 to 8 percent annually in the near future.

Members of the alliance are in the process of sharing information on insurance claims in an effort to pinpoint problem areas or trends, which the group has dubbed as costly “hot spots.”

So far at least two of the five organizations identified treating neck and back pain as one of the most significant drivers in their rising health insurance costs, said Aspen hospital CEO Dave Ressler. Neck and back pain is something that can be expensive to diagnose and treat depending on the extent of the injury, because it typically leads to a costly MRI, which may or may not be necessary, he said. Currently local physicians order MRIs based on their own set of criteria, which might not be based on best practices, he said.

 Chris Council/Aspen Daily News
Radiology and MRI technician Connie Leonard gives instructions to patient Linda Vieira on a recent morning at Aspen Valley Hospital before she undergoes the imaging process.

Last year, the hospital performed about 1,200 MRIs that cost an average of $3,340 per test, according to Bart Outzen, imaging director at AVH. A significant number of those were for spine studies, Outzen said. The most expensive MRI tests cost $4,366 and the cheapest run $2,315, he said.

A group of about 20 local physicians are currently working together as a part of the alliance’s Clinical Integration Committee to identify the best practices used to successfully treat neck and back pain in the most cost effective way, Ressler said. Once the committee of physicians decide on those best practices, a standard protocol will be implemented communitywide, Ressler said.

“What we want to do is learn what the evidence-based best practices are in the country and model ourselves after those,” Ressler said.

Starting with neck and back pain makes sense, because those injuries are fairly well defined and a best-practice protocol doesn’t exist for ordering an MRI, he said. Hopefully, the effort will lead to fewer unnecessary MRIs being ordered, he said.

Outzen thinks the alliance’s work is a worthy effort, he said.

“I think for the majority, most physicians would be receptive to the concept of using best practices in ordering MRI exams,” Outzen said.

The alliance hopes to have an outline of the best practices for treating spinal injuries in the upcoming months, Ressler said.