Interdisciplinary Care

Interdisciplinary programs have been found to be cost-effective. Implementation costs have been estimated for the Veterans Health Administration (VHA) and would likely be higher for other hospital systems.

Evidence for the intervention

Evidence describing interdisciplinary care comes from multiple systematic reviews citing low to moderate quality evidence. These reviews draw from randomized control trials sampling from populations that include low back pain, fibromyalgia, and multiple chronic pain conditions. Trials included in these systematic reviews generally had small sample sizes and a lack of clinician and participant blinding, which limited the quality of their findings. Studies examining real-world application of interdisciplinary care note differences in specific treatments offered, but future research is needed to understand which specific components of interdisciplinary care programs are essential to achieving clinical outcomes, and for whom specific components are most helpful. 

Evidence-based Scale

Cost-effectiveness evaluations of interdisciplinary programs have found that these programs are able to achieve reductions in pain and time to return-to-work more cost-effectively than alternative treatments like spinal surgery, spinal cord stimulators, and implantable drug delivery systems. Compared to spinal surgery, interdisciplinary care is estimated to provide similar outcomes at ~45% of the cost.

Claims data for interdisciplinary programs between 2013-2016 found participation in interdisciplinary care was associated with a ~$750 per person per month reduction in total cost of care (including prescription medication costs) and a ~$850 per person per month reduction in total healthcare costs when excluding prescription medication costs. These cost savings were attributed to reduced use of diagnostic imaging and acute inpatient admissions.

A study that used implementation facilitation to start up interdisciplinary pain management teams at three VHA facilities provided an overview of activities related to starting up a new interdisciplinary pain team and estimated implementation and intervention costs.

Implementation costs were estimated at approximately $40 less at VHA sites than at non-VHA facilities ($536 per month versus $572), demonstrating a small but significant cost reduction.

Intervention costs were estimated at $246 more per patient per three-month interval compared to usual care. These costs would likely be larger in the private sector, as they would also include additional costs like physical space, supplies, and technology. While these estimates provide a framework for potential activities related to interdisciplinary pain care implementation, it is expected that healthcare system and facility costs may vary widely based on the availability of existing resources.

Interdisciplinary programs may also seek accreditation from the Committee on Accreditation of Rehabilitation Facilities (CARF), a nonprofit, independent agency that provides accreditation to programs that meet specific organizational and program standards.