MIBAC FAQs

What is the Michigan Back Collaborative (MIBAC)?MIBAC is a statewide quality improvement collaborative with an initial focus on better care for low back pain within the first 6 months of an episode or acute flare of back pain. The current activities focus on Primary Care Physicians (PCPs) and Chiropractors, with program input from multiple disciplines including PM&R and Emergency Medicine.

What are the components of the program?Low back pain can be frustrating for both patients and clinicians. There is often no single cause for the pain that can be “fixed” with one simple approach to treatment. There can be unnecessary imaging studies and referrals, utilization of unproven therapies, overusing opioids, and dissatisfied patients who never get effective pain relief.

There are three pillars or components of MIBAC:

1-Quality Improvement
2-Compelling Resources
3- Education

Quality Improvement involves Patient-Reported Outcomes (PROs) plus the entry of clinical and demographic patient information into our registry. The data contributed during Quality Improvement populates the MIBAC registry and allows the collaborative to review and analyze data from the registry to identify “best practices” and opportunities for improvement. Furthermore, it enables us to work together on both state-wide and locally-focused quality improvement initiatives as a group.

Compelling resources is an area of the program that is newer, but is growing fast. Currently, we offer resources for patients and clinicians on our website in the form of videos, hand-outs, and other printable materials. In the future, we plan to offer clinical decision-making algorithms, apps, and other tools to improve the ease of caring for patients with acute back pain.

In 2024, we will roll-out a new training experience with clinical vignette-style modules. These modules provide CME/CE credit as well as maintenance of certification for MDs. We are working with the experts at QURE HealthcareTM to develop custom modules that build off of lessons-learned, current evidence, and will one day build off the program's best-practices identified thru Quality Improvement activities. Our executive committee is actively engaged in building, reviewing, and approving these modules.

MIBAC will involve physician organizations and individual BCBSM-contracted chiropractors from throughout the state. The Coordinating Center will be based at Henry Ford Health in Detroit, supported by Blue Cross Blue Shield of Michigan (BCBSM) as part of the Value Partnerships program. Although Blue Cross Blue Shield of Michigan and MIBAC work collaboratively, the opinions, beliefs, and viewpoints expressed by the author do not necessarily represent the views of BCBSM or any of its employees. The MIBAC Registry and Patient Reported Outcome (PRO) platform with built-in analytics is provided by PatientIQ.

How do I participate in MIBAC?Currently, we are working with BCBSM on the MIBAC Strategic Plan. Please check back in April for information about program participation.

How can I ask questions or trouble-shoot issues with participation?What type of support is available if I have any questions or issues with participation?
Program support is available at 313-705-4176 (the MIBAC Coordinating Center), [email protected], or by filling out the “contact us” form below. Technical support is available by sending an email to [email protected]. This creates a ticket which is tracked in our system to insure adequate follow-up and resolution.

During normal business hours, we can usually assist you right away. After business hours, please leave a message and we will reach out to you on the next business day

What is on the horizon for the collaborative?Currently, we are working with BCBSM on the MIBAC Strategic Plan. Please check back in April for information about program participation.

Who can participate in MIBAC?
Currently, we are working with BCBSM on the MIBAC Strategic Plan. Please check back in April for information about program participation.

Why should this be important to me?

Why is back pain so important?
Low back pain can be frustrating for both patients and clinicians. There is often no single cause for the pain that can be “fixed” with one approach to treatment. There can then be unnecessary imaging studies and referrals, use of unproven therapies, over-use of opioids, and dissatisfied patients who never do get effective relief of pain.

Back pain is the leading cause of disability worldwide, and has been shown to be a significant risk factor for suicide.

What are the goals of the collaborative?
The goal of MIBAC is to decrease the rate of conversion from acute to chronic low back pain. Our belief (backed by research) is that the first encounter with their healthcare provider after the onset of low back pain can substantially impact the outcome. We are collecting data points in our registry from the first visit for the episode of pain, such as details on the referrals made, medications recommended, and tests conducted or ordered, along with Patient Reported Outcome (PRO) surveys completed by the patients at baseline, 1 month, 2 months, 3 months, and 6 months.

The intent is, through thorough data analysis, to identify correlations for further investigation. (E.g., patients who are not prescribed opioids have better outcomes at 3 months). We are focusing on the PROMIS Pain Interference (PROMIS PI) which will collect "T" scores from the patient surveys, as well as the STarT Back tool at baseline to stratify the patient's level of risk into one of three categories. To collect these metrics, we are working closely with PatientIQ.

PatientIQ has built our registry and manages the platform, assists with data analysis, performs complex reporting, troubleshoots user-challenges, and advises the MIBAC Coordinating Center in many areas of the quality improvement (QI). The collaborative quality improvement activities will use the registry data to identify approaches that seem to yield the best outcomes with the greatest efficiency, and then use the collaborative structure to spread those practices across the state.

MIBAC offers training programs designed to give “first-contact” clinicians an effective set of tools and protocols with which to deal more effectively with patients with low back pain. Past experience with these programs suggests that significant improvements in patterns of care will occur. Our current training is a 90-minute on-demand module designed and presented by the team at Spine Care Partners, and is only available until December 31, 2023. Email us for questions about eligibility for the $100 training incentive. Click here to take the training.

The overall goals of MIBAC are better and more effective care patterns, better outcomes for patients, and greater satisfaction for both clinicians and patients.

Why should a Physician Organization (PO), practice, or clinician want to participate?
The fundamental reason to be involved in MIBAC is better patient care and better outcomes for a common clinical condition that can be frustrating for patients and clinicians alike. Beyond that, participation in MIBAC should help with standardized performance metrics related to low back pain specifically and to population cost of care more broadly that are used by private and public payors. Based on 25+ years of experience in Michigan with collaborative quality improvement programs, clinicians find them engaging, rewarding, and satisfying as a way to become better at what they do.

Additionally, happy patients return to you, tell their other healthcare providers about the care you provided, and tell their friends. Providing the highest quality care and involving the patient in their care plan will boost patient self-efficacy and improved satisfaction. If you are being "measured" on other metrics (i.e., HEDIS or others), participation in MIBAC can be another way to improve your scores on these measures. If you bring your colleagues from your practice it can streamline how we talk to patients and reduce variations in verbiage, pathways, etc., when sharing patients.

What evidence is there that this type of program will impact outcomes?
The Collaborative Quality Initiative (CQI) program has been highly effective in improving the health of our state, by investigating, educating, and incentivizing high-quality care. Clinicians want to help their patients! When they are shown proof of efficacy for a treatment technique, medication, referral pathway, etc., they will adopt those changes to do what is best for their patients, and the CQI model guides that process, collects relevant existing research, performs pilots with participating sites, educates the state (and further), and collaborative celebrates successes.

The collaborative quality improvement activities follow the pattern of more than 20 other BCBSM-supported statewide improvement collaboratives that have consistently demonstrated tangible improvements in processes and outcomes of care, and real savings to employers and citizens of Michigan in general who incur the cost of medical care. Henry Ford Health houses the Coordinating Centers for MIBAC, MSSIC (Michigan Spine Surgery Improvement Collaborative), and MiMIND (Michigan Mental Health Innovation Network for Clinical Design), and the remainder of the Coordinating Centers are housed at Michigan Medicine / University of Michigan Health System.

The collaborative quality improvement activities follow the pattern of more than 20 other BCBSM-supported statewide improvement collaboratives that have consistently demonstrated tangible improvements in processes and outcomes of care, and real savings to employers and citizens of Michigan in general who incur the cost of medical care.

How can I ask questions or trouble-shoot issues with participate?
The most effective way to get support from our team is to email us at: [email protected]

Emailing us at the address above creates a ticket in our system and notifies all of us that someone needs assistance. Between 8:30 am - 4:00 pm Monday-Friday, A team member sees the ticket and routes it to the individual best able to respond, and it is tracked through our system from the day the email is received through the time the ticket was closed. Program support is also available at 313-407-6195 (the MIBAC Coordinating Center), [email protected], or by filling out the “contact us” form on this website. 

During normal business hours, we can usually assist you right away. After business hours, please leave a message and we will reach out to you on the next business day

Participation Details

When does participation begin?Currently, we are working with BCBSM on the MIBAC Strategic Plan. Please check back in April for information about program participation.

If I am really engaged and want to fully participate, do I need to travel?
For clinicians engaged in the training activities or in Quality Improvement activities, there is no travel required. We do hold annual in-person meetings in Southeast, Mid/West, and Central/North Michigan as well as 1x per year virtually via Zoom. These meetings are 2 to 3 hours long, usually include a guest speaker as well as presentations from our directors, and of course a delicious dinner is provided to our guests. We find that these meetings are very engaging for our providers and are a good opportunity to network with like-minded colleagues.

As a participant, how can I get assistance or ask a question?
The most effective way to get support from our team is to email us at: [email protected]

Emailing us at the address above creates a ticket in our system and notifies all of us that someone needs assistance. Between 8:30 am - 4:00 pm Monday-Friday, A team member sees the ticket and routes it to the individual best able to respond, and it is tracked through our system from the day the email is received through the time the ticket was closed. Program support is also available at 313-407-6195 (the MIBAC Coordinating Center), [email protected], or by filling out the “contact us” form on this website. 

During normal business hours, we can usually assist you right away. After business hours, please leave a message and we will reach out to you on the next business day.

Contact

Michigan Back Collaborative
Henry Ford Health

Office of Clinical Quality & Safety

1 Ford Place

Detroit, Michigan 48202

 

313-407-6195

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