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The Origin

STEPWISE is an initiative founded in 2021 by Colorado Integrated Care Network, or CICN. CICN is a value-based musculoskeletal provider network in Colorado. Between 2018-2020, CICN was engaged in several large-scale studies that aimed to uncover why costs associated with musculoskeletal complaints had grown so rapidly, and whether or not this growth was associated with better quality care.

The studies determined that 27-34% of costs for musculoskeletal care in the Colorado Front Range are unnecessary. The studies tracked costs on over 100,000 patients. It was determined that between 78-94% of these unnecessary costs can be avoided by steering patients to the "right care, right time, right provider". 

And thus, STEPWISE was born out of a collaboration between CICN and Colorado value-based primary care providers.

The Current

STEPWISE uses big data to project outcomes and total cost of care based on patient presentation. As the data becomes more robust we expect greater accuracy in predicting outcomes and cost. Currently, predicted outcomes and cost are accurate in over 85% of cases.

An important component of STEPWISE is directing patients to the most efficient and appropriate care. This reduces rates of unnecessary surgery, medications, injections, and costly diagnostics such as MRI's. STEPWISE directs patients to one of the following care pathways based on responses to the assessment questions;

  1. Home care with virtual symptom monitoring managed by a multidisciplinary team;

  2. in-office conservative care, such as physical therapy or chiropractic;

  3. primary care/family medicine; or

  4. specialist consultation, such as a physiatrist, pain management specialist, or surgeon.

Providers qualify for inclusion into the STEPWISE network by achieving outcomes and total cost of care averages that place them within the top 25% in their market. 

The Future

STEPWISE is the sort of market initiative that can reduce health care costs dramatically, and even reduce the health insurance premiums consumers pay. It is our goal to make STEPWISE the preferred shared decision-making platform in Colorado and beyond. What do you say? Will you help us spread the word?

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