Musculoskeletal (MSK) Program
Including Spine and Orthopedic Implant Management
HealthHelp provides a fully integrated pain, spine, musculoskeletal, and orthopedic implant program for management of chronic pain and bone and joint health.
Program Overview
Utilization of proprietary guidelines developed from published clinical evidence-based studies
- >10% impact on MSK surgeries
- >25% impact on inpatient redirection
- >6% impact on pain management
- Increased appropriate use of physical therapy with proven improvement in patient outcomes
- Significant overall decrease in surgical interventions and implants
- Greater consumer engagement via effective member-centric health and wellness and incentive programs
- Specific decrease in low-back pain-related spinal interventions
- Improvement in quality and safety for members thus qualifying for the MLR requirement under ACA law
Meet the Medical Director
Harbinder Chada, MD |
Medical Director of Musculoskeletal Services
Dr. Harbinder Chadha is an orthopaedic surgeon affiliated with Sharp Chula Vista Medical Center and Scripps Mercy Hospital. He holds certification from the American Board of Orthopaedic Surgery and is a member of professional organizations including the American Medical Association, the American Academy of Orthopaedic Surgery, the Western Orthopaedic Association and the California Medical Association. For his undergraduate degree, Dr. Chadha attended Alma College, graduating summa cum laude. He pursued his medical degree at the Wayne State University School of Medicine. Dr. Chadha completed his residency training at the university’s Department of Orthopaedic Surgery, followed by a fellowship program in adult reconstruction at Scripps Clinic and Research Foundation.
Member Clinical Information*
- Member history (falls, injuries, or stress)
- Onset of pain
- Direction of pain
- Nature of pain (shooting, stabbing)
- Relief/aggravation causes
- Differentiation of pain
- Other member symptoms
- Current or suspected diagnosis
- Clinical indication
- Summary of Clinical Findings (range of motion)
- Radiologic findings (joint space preservation)
- Functional assessment
- Reason for test
- Test ordered
- Treatment, procedure, or device Requested
- Member medications and duration (use of analgesics)
- Prior medical management history
- Prior use of injectables and branch blocks
- Prior invasive procedures or surgeries
- Osteoarthritis (OA)
- Rheumatoid arthritis (RA) and juvenile RA (JRA)
- Avascular necrosis (AVN) or osteonecrosis (ON)
- Congenital dislocation of the hip joint (CDH)
- Hip dysplasia
- Acetabular dysplasia (shallow hip socket)/protrusion
- Benign and malignant bone tumors
- Paget’s disease arthritis
- Ankylosing spondylitis
- Frozen, stiff, loose joint
- Traumatized and malaligned joint
- Fractures
Automated Decision Support
Providers submit procedure requests. If the request meets evidence-based criteria, it is automatically approved.
If the request falls outside of pre-set clinical guidelines, it is sent to nurse review.
Specialty Nurse Review
HealthHelp nurses evaluate requests, gather additional information and provide approvals for requests that meet clinical guidelines. For requests that fall outside of these criteria, nurses will present an alternative care pathway as guided by the proprietary Clinical Decision Support system.
If not approved at the nurse review level, the request is sent for a peer-to-peer consultation.
Peer-to-Peer Consultation
A HealthHelp physician reviews the request. After consultation with the requesting provider, the request will either be approved by the expert reviewer, or withdrawn/changed by the requesting provider.
Medically Appropriate Procedures*
The program covers the use of diagnostic procedures, invasive interventional procedures, PT/OT therapies, injectables, prostheses, and surgical implantable devices.
Non-Surgical Pain Management:
- Physical Medicine Pain Treatments
- Epidural Steroid Injections
- Facet Joint and Medial Branch Blocks
- Sacroiliac (SI) Joint Injections
- Intrathecal Morphine
- Intrathecal Morphine Pump
- Spinal Cord Stimulators (neurostimulators)
Surgical Pain Management:
- Artificial Disc
- Intrathecal Pain Pump
- Kyphoplasty/Vertebroplasty
- Lumbar Discectomy
- Lumbar Endoscopic Discectomy
- Lumbar Foraminotomy
- Lumbar Foraminotomy/Facetectomy
- Lumbar Fusion
- Lumbar Laminectomy
- Minimally Invasive Lumbar Surgery
- Spinal Cord Stimulator
Spine Management/Hip and Knee:
- Single and Double-Lock Screw Systems
- Spinal Corpectomy Cages
- Cervical Plate Systems
- Steffee Implants
- Harrington Implants
- Neurostimulators (Spine)
- Drug Infusion Systems (chronic pain, spasticity)
Upper Extremity, Wrist, Femur, Tibia, Shoulder, Elbow, and Foot:
- Myoelectric prosthesis
- Body-powered prosthesis
- Constrained vs. Unconstrained
- Condylar blade plate
- Grosse-kempf (GK) nail
- Buttress plate
- Neer’s prosthesis
- Souter’s prosthesis
- Baksi’s prosthesis
- Single axis
- SACH Dynamic response