Just as the Guidelines for Chiropractic Quality Assurance and Practice Parameters (Mercy Guidelines) had an important impact on the Agency for Health Care Policy and Research's guideline, Acute Low Back Problems in Adults, the AHCPR guidelines are now influencing other guidelines developed by government agencies and employers across the United States. According to the most recent issue of Research Activities,1 an AHCPR publication, this is just a sample of the impact:
California
The California Division of Workers' Compensation has used or is using AHCPR's low back guideline to develop their own back treatment guidelines.
Zenith Insurance Company, a Woodland Hills-based insurer, has cut costs for back pain treatment by 65 percent, in part by creating treatment protocols based on AHCPR's acute low back guideline and sending the protocols to physicians who treat workers' compensation patients.
Colorado
The Colorado Department of Labor and Employment has used or is using AHCPR's low back guideline to develop their own back treatment guidelines.
Connecticut
The Connecticut Workers' Compensation Commission has used or is using AHCPR's low back guideline to develop their own back treatment guidelines.
Florida
Florida's Agency for Health Care Administration developed a practice guideline for treating low back pain based largely on AHCPR's guideline. It is expected to save the state nearly $100 million in a single year of workers' compensation direct health care costs.
Gulf Atlantic Management Group, a large preferred provider network, is integrating copies of AHCPR's Acute Low Back Problems in Adults into its manual for current physician providers and newly contracted PPO and HMO providers. Kentucky
Kentucky now requires insurers handling workers' compensation claims for back injury to use the state's new low back pain practice parameter as the standard for utilization review. The parameter closely follows AHCPR's acute low back guideline.
Montana
The Montana Department of Labor and Industry has used or is using AHCPR's low back guideline to develop their own back treatment guidelines.
New Jersey
At Bristol Meyers' New Brunswick, New Jersey facility, the AHCPR acute low back problems guideline is helping physicians treat employees' low back problems successfully for one-fifth of the national average cost.
New York
Employees of Consolidated Edison Company of New York, Inc., who were treated for acute low back pain according to recommendations in AHCPR's guideline returned to work about two weeks sooner than workers treated by more traditional methods.
Oklahoma
The Oklahoma Workers' Compensation Court has used AHCPR's low back guideline to develop their own back treatment guidelines.
Texas
Houston-based WorkCare, Inc. has used the AHCPR guideline to curb medically unnecessary MRI scans and contest other claims that appear unjustified, such as overuse of prescription medicines.
The Texas Workers' Compensation Commission has used or is using AHCPR's low back guideline to develop their own back treatment guidelines.
Utah
The Utah Industrial Commission has used or is using AHCPR's acute low back problems guideline to help develop their own back pain treatment guidelines.
Nationally
Hewlett-Packard developed a company protocol for handling employees' back problems that closely parallels the recommendations in AHCPR's guideline.
Reference
1. AHCPR-sponsored guidelines help users increase quality and cut costs. Research Activities, Vol. 194, June, 1996.
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