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J Occup Environ Med. 2019 Jan 10. doi: 10.1097/JOM.0000000000001536. [Epub ahead of print]

Integrated Physical Medicine at Employer-Sponsored Health Clinics Improves Quality of Care at Reduced Cost.

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Crossover Health, San Clemente, CA (Daniel J. Lord, John R. Wright, Rebecca Fung, Eric S. Lederhaus, Katie Taylor, Sharon A. Watts, Heather K. Hagg, Dena Bravata); Stanford University, Center for Primary Care and Outcomes Research, Stanford, CA (Dena Bravata); Untold Content, Cincinnati, OH (Katie Taylor, Sharon A. Watts).



To evaluate clinical and economic outcomes associated with integrating physical medicine in employer-sponsored clinics.


Retrospective cohort analysis comparing clinical and economic outcomes of physical medicine services delivered in employer-sponsored clinics with the community.


Integrating physical medicine in employer-sponsored clinics decreased wait times to access these services to 7 days (2-4x faster than in the community). Patients receiving care in employer-sponsored clinics experienced marked improvements in fear of pain avoidance behaviors (p < 0.00001) and functional status (p < 0.01) in 8 fewer visits than in the community (p < 0.0001), resulting in $472-$630 savings/patient episode. Non-cancer patients received 1/10 the opioid prescriptions in employer-sponsored clinics compared to the community (2.8% vs. 20%). Patients were highly likely to recommend integrated employer-sponsored care (NPS = 84.7).


Findings suggest robust clinical and economic benefits of integrating physical medicine services into employer-sponsored clinics.

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