title: Impact of a value-based insurance design for back pain on health plan member satisfaction and its implications for patient outcomes.
abstract: Back pain is one of the most common reasons for seeking care, and physical therapy (PT) can be an effective treatment option. However, PT coverage for back pain varies widely among private health plans, usually requiring high cost sharing, thereby potentially leading to member dissatisfaction and worse outcomes. In this study, a quasi-experimental design was used to estimate the impact of a new value-based insurance design for back pain-related PT on selected Consumer Assessment of Healthcare Providers and Systems survey items. Under this design, eligible members receive a bundle of 5 PT sessions for a 1-time co-payment; if deemed necessary, the bundle is renewable for 1 additional co-payment. The results indicate that the proportion of members reporting the highest satisfaction rating was higher by about 6 to 10 percentage points among those who received the PT bundle. The data also indicate that those PT bundle members who reported the highest satisfaction rating had improvements in their functional status scores that were roughly 3 to 4 times higher than those who reported a lower satisfaction rating. These findings suggest that providing a value-based insurance design for back pain-related PT can potentially improve health plan members' care experiences and their overall satisfaction. Further study is needed to determine its impact on back pain-related medical care utilization and cost of care.
authors.affiliation: 1Geisinger Center for Health Research, Danville, Pennsylvania.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Maeng
authors.affiliation: 2New West Health Services, Helena, Montana.
authors.forename: Dorothy Y
authors.initials: DY
authors.lastname: Fisher
authors.affiliation: 3Geisinger Health Plan, Danville, Pennsylvania.
authors.forename: Anthony
authors.initials: A
authors.lastname: Graboski
authors.affiliation: 3Geisinger Health Plan, Danville, Pennsylvania.
authors.forename: Peiling L
authors.initials: PL
authors.lastname: Allison
authors.affiliation: 3Geisinger Health Plan, Danville, Pennsylvania.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Rodriguez
authors.affiliation: 3Geisinger Health Plan, Danville, Pennsylvania.
authors.forename: Alison E
authors.initials: AE
authors.lastname: Starr
authors.affiliation: 3Geisinger Health Plan, Danville, Pennsylvania.
authors.forename: Janet F
authors.initials: JF
authors.lastname: Tomcavage
authors.affiliation: 3Geisinger Health Plan, Danville, Pennsylvania.
authors.forename: Duane E
authors.initials: DE
authors.lastname: Davis
mesh_terms: D001416:Back Pain / Q000209:etiology / Q000534:rehabilitation; D003669:Deductibles and Coinsurance; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D019458:Insurance Coverage / Q000191:economics* / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D059408:Pain Management / Q000191:economics*; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities / Q000191:economics*