Join the Alliance’s Effort to Transform Care for Low-Back Pain

This summer we released Aligning to Drive Value, a white paper describing our progress on a grant-funded project that leveraged the Alliance’s data and convening efforts with eight of our purchaser members representing more than 500,000 covered lives in Washington State. The primary aim of the effort was to use data-driven insights and collaboration to inform and motivate purchasers to improve the value of care for their plan participants, both individually and collectively.

The Alliance developed customized reports for each purchaser that identified high-value improvement opportunities using a subset of Community Checkup measures, such as access to primary care, screenings, condition management, and medication. These insights were coupled with low-value reduction opportunities using the Milliman MedInsight Health Waste Calculator™. The Alliance team engaged the purchasers in multiple collective discussions to dig into the results from this analysis and understand their priorities for action. While there were many meaningful opportunities for value improvement discussed, the purchasers agreed to focus on improving the care for low-back pain in collaboration with providers and health plans.

The selection of low-back pain was influenced by the strong evidence for non-opioid, non-invasive care and opportunities to improve implementation of that evidence in practice. The collaborative discussions involving purchasers, providers, and health plans produced strong agreement that there are meaningful opportunities to improve on the care of low-back pain and that the incentives for patients to seek and receive the most appropriate care are oftentimes lacking and/or misaligned for both patients and providers. This persists in spite of strong evidence in the literature and agreement among Washington stakeholders as demonstrated by the Bree Collaborative workgroup on low-back pain in 2013, as well as the more recent work of the Bree focused on pain management and shared decision-making.

We are pleased to share the news that Arnold Ventures is supporting the efforts of the Alliance and its members to change this through the formation of a Low-Back Pain Implementation Collaborative. The Implementation Collaborative will bring together purchasers, providers, health plans, and other key stakeholders to implement specific steps that will achieve these patient and provider-focused strategies identified in the Driving Value Project.

  • Patients: Activate individuals to seek evidence-based care for low-back pain through education and benefit design.
  • Providers: Ensure financial incentives and practice-level resources are aligned with and facilitate evidence-based care of low-back pain.

There is strong commitment from many key stakeholders and the Alliance is poised to launch the effort with their support this fall. We continue to welcome others to the table and encourage all those who have a strong interest in improving the care for low-back pain by relying on the evidence and taking action to ensure that high quality, affordable care happens more consistently and broadly for all in Washington state, to join us. Please contact me at ngiunto@wahealthalliance.org if you are interested in participating.

One of the most gratifying aspects of working with purchaser leaders in the initial phase of this project was their commitment to change. When low-back pain was selected as the area to focus on for implementation, they were universally emphatic in their commitment that this be the first of many such initiatives we undertake together at the Alliance.

I would like to express our deep appreciation to Arnold Ventures, whose support allows us do this important work and to you, our members, without whom this work would not happen.

I look forward to keeping you apprised of the progress our multi-stakeholder leaders make together!

All the best,


Published: October 4, 2021

About Washington Health Alliance

The Washington Health Alliance is a place where stakeholders work collaboratively to transform Washington state’s health care system for the better. The Alliance brings together organizations that share a commitment to drive change in our health care system by offering a forum for critical conversation and aligned efforts by stakeholders: purchasers, providers, health plans, consumers and other health care partners. The Alliance believes strongly in transparency and offers trusted and credible reporting of progress on measures of health care quality and value. The Alliance is a nonpartisan 501(c)(3) nonprofit with more than 185 member organizations. A cornerstone of the Alliance's work is the Community Checkup, a report to the public comparing the performance of medical groups, hospitals and health plans and offering a community-level view on important measures of health care quality (www.wacommunitycheckup.org).

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