Spine and Joint Care Program

Treating back and joint pain can be a costly experience for you and your employees. This Blue Cross Blue Shield of Michigan program focuses on appropriate and effective treatment that reduces cost.

1.
About 127 million people in the U.S. live with a condition that affects their muscles, bones, joints and associated tissues.
2.
These conditions are responsible for an estimated $213 billion in costs associated with treatment, care and lost wages, each year.
3.
Our program helps your employees get safe, appropriate and cost-effective treatment.

How it works

Our Spine and Joint Care Program addresses the cost and care for treating muscle, bone, joint, tendon and ligament issues.

Treatment for these health issues can be quite costly for your employees and your business. At Blue Cross, we've found there are two issues in this field of care: providers not adhering to clinical guidelines and price variation.

Even though there are established guidelines, they're not always followed. And, where someone goes for care really matters when it comes to the price tag. It can significantly affect their costs. This can result in unnecessary care that can lead to poor outcomes and higher costs.

This is where we can help. We've come up with two main components to address these concerns.

MSK Surgical Quality & Safety Management Program

With this program, we help make sure health care providers are following evidence-based guidelines and providing clinically appropriate care. Following these guidelines helps lead to:

  • Faster recovery times
  • Lower risk of more surgery
  • Fewer complications and infections
  • Care provided at the right time, in the right setting 

This is accomplished through prior authorization and clinical review of spine and joint surgeries and pain procedures. Our program also offers peer-to-peer discussions with health care providers. We provide comprehensive reporting that demonstrates the impact of the program.

Designated specialty providers

Blue Cross has carefully selected certain providers as participants in this program. These are high-performing, quality providers who manage costs well for musculoskeletal surgeries. 

When your employees need this kind of care, they can find the designation while using our Find a Doctor tool. Not only that, they can also get rewarded and better understand their costs through our Spine and Joint Care Rewards program.

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