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2021 Innovation Awards: Virtual Functional Restoration

2021 Innovation Awards

Virtual Functional Restoration

When CorVel Corp. set out to create a model for treating patients with chronic pain using a virtual approach that emphasizes behavioral therapies, the claims management company had to overcome some long-established traditions around patient care.

Chronic pain management has traditionally focused on biomedical models that rely heavily on medical intervention, and treat patients largely with medication and surgery, said David Lupinsky, vice president of digital health and innovation at CorVel in Sacramento, California. It’s been a challenge to convince some in the medical community that a more holistic way of treating patients can lead to better outcomes, he said.

CorVel, however, has managed to change attitudes, treat chronic pain patients with a broader approach to wellbeing and help risk managers resolve claims faster with its Virtual Functional Restoration program, a winner of a 2021 Business Insurance Innovation Award. 

The program identifies cases in which injured workers’ progress toward recovery is slow, and, therefore, resolution of the claim is likely to be delayed, Mr. Lupinsky said.

Signs that a patient is at risk include frequent emergency room visits or long-term use of medications, he said.

If the risk manager and claims adjuster agree that a patient’s care could benefit from a virtual functional restoration approach, CorVel asks the patient’s physician to allow it to become a secondary provider. 

“We’ve found that a lot of providers are looking for help with this population,” Mr. Lupinsky said. “If they agree, we reach out to the patient through telehealth and start to interact with them as a secondary provider.”

Traditional care is often provided by doctors, physical therapists and psychologists in silos, with little interaction among them, he said. The virtual program allows care providers to easily interact in an online setting, he added. 

“With telehealth, it’s much easier to get everyone in the exam room because it’s not bound by geography,” he said.

The program of medical, physical and behavioral health care is conducted virtually, and only in rare cases when a patient may benefit from a medical procedure are they referred to an outside provider, Mr. Lupinsky said.

Risk managers benefit from the program’s ability to identify chronic pain cases at risk of delayed recovery, allowing them to address those cases early, accelerating resolution of the claim and making sure injured workers can get the care that will allow them to return to work, he said.

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