Managed Physical Medicine

New Musculoskeletal Treatment Recommendations Echo MedRisk Program

A 2019 systemic review of high-quality clinical practice guidelines has yielded a set of 11 key recommendations for best-practice musculoskeletal treatment – all of which have been historically supported by the MedRisk Platinum Grade Program for Physical Medicine.

In a recent article published in the British Journal of Sports Medicine, a multidisciplinary research team identified 11 clinical practice guideline (CPG) recommendations for treating adult musculoskeletal pain. The recommendations are the product of a systemic review of 44 CPGs addressing spinal pain, hip/knee pain and shoulder pain. The authors contend that practice aligned with these guidelines results in “better outcomes and lower costs;” however, there can be barriers to integrating the recommendations into daily practice, including a lack of guidance for implementation.

As a leading physical medicine managed care organization, MedRisk works to close these “evidence-to-practice gaps” by supporting our expert providers with patient-centered services, education and our own evidence-based guidelines focused on rehabilitating the injured worker.

In this article, we take a closer look at the study authors’ 11 recommendations and how they are addressed by the MedRisk Platinum Grade Program for Managed Physical Medicine.

Patient-Centered Services

Fittingly, the first recommendation from the study authors is “Care should always be patient-centered.” The dedicated physical therapists (PTs) in our provider network live this principle every day in the treatment they provide, and MedRisk helps facilitate patient-centered care as soon as a case hits our desk. Our representatives use a dynamic scheduling algorithm to match patients with a provider who is equipped to meet their treatment needs and who can see them as soon as possible.

Many providers routinely conduct an assessment that includes a physical examination (Recommendation 5) and screening for “red flag” conditions (Recommendation 2) at the start of treatment. But even before the initial evaluation, MedRisk’s on-staff PTs first conduct a phone consultation. The conversation helps identify psychosocial factors like anxiety and catastrophic thinking (Recommendation 3) that may be a roadblock to recovery. After this initial interaction, the MedRisk PT can help facilitate better understanding and communications about the patient’s unique case in advance of the physical evaluation and treatment.

This phone consultation is also used as an opportunity to educate patients about their condition and treatment (Recommendation 7). Patients learn about next steps in their rehabilitation and the important role they play as an active participant in the recovery process. When applicable, this can include a discussion of why exercise and physical activity is often a key component of treatment, as discussed in Recommendation 8. Should the patient be identified as an ideal candidate, a MedRisk PT will also present the option of the MedRisk Telerehabilitation Program, which can support the patient’s transition to independence and help ensure compliance with exercises prescribed during treatment.

MedRisk’s Evidence-Based Treatment Guidelines

Recommendation 11 from the study authors states that “treatment should facilitate return to work” and encourage patients to remain active and engaged throughout their recovery. MedRisk supports successful return to work with the only evidence-based guidelines in the industry specific to physical medicine and the injured worker. These proprietary guidelines are continuously updated to incorporate new research in the field, including developments related to therapies, comorbidities, psychosocial factors and barriers to recovery. For example, the study authors’ ninth recommendation is “Manual therapy should be used only as an adjunct treatment,” and manual therapy and the application of other modalities are detailed in the MedRisk guidelines.

Throughout treatment, MedRisk takes an active role in monitoring progress and facilitating communication between providers and case manager/adjusters so that as patients are benchmarked against “validated outcome measures” (Recommendation 6), all parties can ensure the injured worker is on track with their current treatment plan.

Knowledge Sharing

Research in the field of physical medicine continues to yield new approaches and emerging therapies. MedRisk keeps a pulse on these developments and disseminates content regularly to our provider network. In recent years, growing evidence has led the industry to promote nonsurgical care as first-line treatment (Recommendation 10). This finding has been promoted in MedRisk study spotlights and newsletter articles. Likewise, the study authors advise against the use of radiological imaging except when a serious pathology is suspected (Recommendation 4) – which is an approach we have also promoted to our provider network.

MedRisk aims to share leading-edge research and to incorporate the latest evidence-based findings into our operations. The fact that our programs and services align with these 11 core recommendations suggests that our Platinum Grade Program for Managed Physical Medicine delivers what constitutes high-quality musculoskeletal care.

To learn more about this study and related recommendations, click here.