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Tens of Thousands of Back Pain Patients Overtreated in Six Health Plans, According to HealthCore Study
Date:3/16/2009

or 1 percent) had back surgery within the first six weeks of diagnosis, total health care costs in this time period exceeded $18 million for these patients alone.
  • Members' overall treatment costs and procedures rose in relation to the number of specialists they saw.
  • In 2005, Americans spent $85.9 billion looking for relief from back and neck pain through surgery, doctor's visits, X-rays, MRI scans and medications, up from $52.1 billion in 1997, according to a study in the Feb. 13 issue of the Journal of the American Medical Association. That increase hasn't reduced the number of people reporting back pain. Fifteen percent of adults reported back problems -- up from 12 percent in 1997.

    "This is an area that lends itself to greater scrutiny, clinical study and evidence-based medicine," Nussbaum said. "As a result of the HealthCore study, WellPoint is investigating approaches to support members and physicians to ensure appropriate care can be delivered to all members with back pain."

    About the study

    The study is based on an analysis of clinical measures as established by the National Committee for Quality Association Back Pain Recognition Program. The study included 172,377 individuals with low back pain in six WellPoint health plans who were diagnosed with low back pain from Jan. 1, 2005 through Dec. 31, 2005.

    Members were excluded if they were not with a WellPoint health plan for at least six months before and 18 months after their initial back pain diagnosis. Members were also excluded if they were younger than 18 or older than 64 on Jan. 1, 2005. Members with certain "red flag" conditions, such as cancer, trauma and those with numbness, lack of sensation, loss of reflexes, and symptoms associated with nerve risk damage, were also excluded.

    Those studied had a median age of 45 years and lived in California, Ohi
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    SOURCE WellPoint, Inc.
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