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PRIUM Steers Payers Toward Best Practice Functional Restoration Clinics

April 24, 2013 - WorkCompWire

Duluth, GA – After agreeing to reduce opioid prescriptions for injured workers, many physicians feel uncomfortable managing the weaning process and want to refer to a more specialized venue. Seeing the need for a standard set of criteria to assess clinics, PRIUM has launched “Centers with Standards,” a service rating functional restoration programs according to their adherence to best practices that can help predict outcomes.

“Our clients need a way to objectively compare the quality of programs; it’s difficult to determine effectiveness from a website,” said Mark Pew, Senior Vice President of Business Development for PRIUM.

Pew spent several years analyzing the features of clinics with good outcomes, leading to the creation of a provider questionnaire. PRIUM processes responses through a proprietary algorithm built from evidence-based guidelines and industry best practices to produce a “Restore Score™.” Clinic data and scores populate a proprietary database accessible by PRIUM clients.

Some of the Restore Score™ criteria include using an inter-disciplinary team approach, inpatient capabilities for the detox process, consistent objective monitoring of progress, and post-discharge follow up. “The clinics with the best outcomes follow patients a year after they complete the program to help prevent relapse,” Pew said.

Functional restoration clinics focus on increasing physical fitness and stamina while addressing the psychosocial issues that that contribute to a patient’s ability to cope with pain. Frequently offering yoga and other fitness classes, the clinics strive to return claimants to work or at least to a functional lifestyle.

Providers apply for their Restore Score™ certification via www.centerswithstandards.com.

“This is not a network,” Pew cautioned. “PRIUM has no financial arrangements with the providers and do not charge clients for the service. It is simply a tool to help payers find the best resources.”

Source: Prium/King Knight

Filed Under: Claims, Legal, & Compliance News, Industry News, Top Stories, Work Force & Human Resource News, Workers' Compensation

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