New NCQA Program Will Recognize Excellence in Caring for Back Pain

The National Committee for Quality Assurance (NCQA) unveiled a new program today that will recognize physicians and chiropractors who give superior care to the approximately 30 million Americans who suffer from back pain.

The Back Pain Recognition Program (BPRP) will identify high-quality physicians and chiropractors who take a patient-centered approach to back pain using 16 evidence-based criteria. These criteria include: thorough patient assessment; recommendations for appropriate physical activity; avoiding unnecessary imaging; patient education and shared decision-making with the patient about surgery and alternatives to surgery; tracking and analyzing surgical outcomes; and surveying patients about their experience.

Back pain is one of the most common ailments in America; about 11 percent of the population experiences pain severe enough to impair their usual daily activities each year, accounting for one-quarter of all workers’ compensation claims. Treatment of back pain accounts for approximately $91 billion a year.

For many patients, acute back pain is best treated with pain management, minimal bed rest and a return to physical activity, since the pain resolves in most patients within 4 to 6 weeks. Yet the treatment offered for acute low back pain in patients without signs or symptoms of more serious disease varies widely, from the recommended approach of pain management and gradual return to physical activity to the premature use of images such as x-rays and CT scans and referral for surgery. Less than one percent of such imaging services actually find the cause of low back pain and patients who avoid the imaging experience no difference in outcomes.

“How back pain is treated varies tremendously from practice to practice, so that where you go for your care is as important as what is causing your problem,� said NCQA President Margaret E. O’Kane. “This program recognizes physicians, chiropractors and those working with them who provide their patients with careful and systematic care for back pain that combines following solid medical evidence with active patient engagement.�

Poor quality back pain treatment is also a major concern of U.S. employers. “Employers want the best care for their employees and dependents. Over-treatment of back pain often leads to people undergoing expensive and sometimes dangerous care that leaves them in worse health,â€? said François de Brantes, National Coordinator for Bridges to Excellence (BTE), a nationally recognized program that encourages improvements in health care quality by recognizing and rewarding providers who offer safe, effective, efficient and patient-centered care. BTE will be launching a Spine Care Link that will provide bonuses and other financial incentives for those who become recognized under the NCQA Back Pain Recognition Program and will actively encourage health plans and employers across the regions of the country in which BTE’s programs are being implemented to roll out the new program.

The Back Pain Recognition Program was developed with input from experts representing orthopedics, neurosurgery, primary care, public health, health plans and employers. In shaping its requirements, NCQA studied some of the best treatment programs in the U.S.

“NCQA has put together a comprehensive set of metrics that will distinguish those who provide patient-centered care. Patients who actively participate in their back pain treatment often choose less invasive forms of care to help restore their health, mobility and ability to work,â€? said James Weinstein, DO, MS, Chair, Department of Orthopaedic Surgery at Dartmouth-Hitchcock Medical Center, one of the nation’s leading spine centers. “We find that patients not only appreciate the time we take to explain their diagnosis and treatment options, but it also facilitates the overall patient centered care model.â€?

“This program will encourage our members who suffer from back pain to seek providers who excel at treating their back pain, while reducing unnecessary treatment and costs,â€? said David Deitz, MD, Ph.D., National Medical Director for Liberty Mutual Group’s workers’ compensation business. “In the case of back pain, good medicine and cost containment are on the same side of the equation.â€?

NCQA will begin accepting applications for the Back Pain Recognition Program (BPRP) in April 2007. BPRP is part of NCQA’s continuing efforts to recognize superior patient care in medical practices. Established programs recognize physicians for excellence in caring for patients with diabetes, heart/stroke patients and for systematically using information to provide comprehensive care to their patients (Physician Practice Connections). For more information about any of these programs, visit and click on ‘recognition programs.’

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations, recognizes physicians, physician groups and other health care providers in key clinical areas and manages the evolution of HEDIS®, the tool the nation’s health plans use to measure and report on their performance. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health choices. For more information, visit

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