Supporting Decision Making for Musculoskeletal Preference-Sensitive Care

A Prospective, Randomized Trial to Assess the Impact of Decision Aids and Health Coaching on Health Care Costs, Surgery Rates, and Decision Quality for Individuals At Risk for Musculoskeletal Preference-Sensitive Surgical Decisions

The purpose of this study is to compare condition oriented whole person Health Coaching along with the provision of decision aids to decision aids without condition oriented Health Coaching to neither condition oriented health coaching nor decision aids on medical cost, preference sensitive surgeries and measures of subject knowledge, decision process and decision quality.

Inclusion Criteria:

• Participants in two large, commercial Blue Cross and/or Blue Shield branded insurance products with eligibility for Health Dialog services
• Identified by distinct Health Dialog proprietary models for risk of lumbar back, knee or hip surgeries
• Selected by simple randomization for inclusion in an interactive voice response (IVR) administered screening survey
• Participated in an IVR-administered screener survey and responded affirmatively to questions on pain for any one of the three conditions, any current or planned treatment for the conditions, and responded negatively to having had a condition specific surgery within the past six months

Exclusion Criteria:

• People under 18 years of age at time of identification for the IVR filtering survey, approximately 6 weeks prior to the start of the study
• People with invalid phone numbers or invalid mailing addresses based on automated review of those fields
• People for whom Health Dialog has information of a request for no IVR, no Health Coach outreach, or mailings prior to the start of the study
• People with claims based indication of spinal stenosis prior to the start of the study
• People who have been targeted for any IVR outreach within 180 days of the initiation of the IVR filtering survey
• People who have a Health Coach communication record, as documented in the Health Coaching application within 90 days of the start of the study
• Any members of households who have a household member already selected for inclusion in the study
• People for whom there is claims evidence of any one of the targeted surgeries prior the start of the study
• People with no eligibility for services through insurer after the start of the study