A pilot between Aetna and the United Parcel Service (UPS) found that employees on short-term disability who completed an online pain assessment and participated in pain management programs for several weeks had a 50 percent higher return-to-work rate and 22 percent shorter duration of disability.
The pilot, which took place in 2016, allowed Aetna to analyze UPS’ disability claims. Six musculo-skeletal diagnoses were flagged. If a claim was submitted with one of the diagnoses, a nurse would provide members with more information on their disability and alternative ways to manage pain.
Dr. Mike Lacroix, associate medical director for Aetna’s Disability and Absence Management Services, said opioids can be prescribed to people who are on disability to manage their pain. If prescribed in high doses, Lacroix added, opioids can lead to chronic pain and result in a longer duration of disability.
“Studies have shown repeatedly that the longer people are on disability, the less likely they are to return to work,” Lacroix said. “What tends to happen when people get off work is they start to be more sedentary. As they’re more sedentary they can become depressed.”
Knowing this, Aetna aimed to educate doctors and members on diagnosis-related pain and how they can best cope with it
If one of the six flagged diagnoses were included in a disability claim, the member would be told about PainCAS, a web-based tool that assesses pain and risk of opioid addiction. Members would answer a series of questions and receive a report detailing the factors behind their diagnosis, Lacroix said. And if they were interested, the member could also access painAction, which offers mobile programs and tools to manage pain.
In principle, educating people on their diagnosis should allow them to better understand what could be contributing to their pain so they would be less dependent on opioids.
“This particular tool is useful and we can use it to educate folks and help them better understand their particular issues and how to better deal with them,” Lacroix said.
Those who used the mobile programs experienced 28 fewer days of disability on average, compared to the one-third of members who did not participate in the pilot. They also had a 30 percent lower migration rate from short-term disability to long-term disability.
“Effective patient-doctor communications are a key factor in making sure that every person — whether in a crisis or not — gets whatever help he or she needs to enjoy optimum care,” said Marty Strang, RN, CCM, WELCOA® Certified, director of clinical strategy analysis for Aetna National Accounts. “The pilot with Aetna and UPS improved patient-doctor communications and the process related to administering and documenting patient pain and opioid risk assessments.”
The PainCAS and painAction tools have also been validated with patients in medical offices and clinics, and Aetna is now looking at further studies.