Application of a Value Model for the Prevention and Management of Chronic Musculoskeletal Pain by Physical Therapists

: For physical therapists, establishing value of care is vitally important in the management of musculoskeletal pain. Value has become an important outcome measure in health care, largely as the result of payment reform efforts aimed at reducing wasteful spending. Providers who can establish the value of their services and be responsive to changing economic demands will be better positioned to deliver care. Establishing value is typically accomplished through comparative and cost-effectiveness studies. However, these approaches stop short of describing the components and processes that drive quality and costs-a necessary step for improving the value of existing services or developing new ones. The Institute of Medicine has recently called for more effective strategies to prevent and manage high-impact chronic pain. A model to guide the development and evaluation of pain management pathways will position physical therapists to best answer the Institute of Medicine's call within an increasingly value-focused health care environment. This perspective article presents a value model for physical therapy that describes how value emerges from interactions among the health care system, health care services organizations, the physical therapist, and the patient. How the model can be used to inform and guide the implementation of value-conscious treatment pathways for the prevention and management of chronic musculoskeletal pain also is discussed.