Chronic Pain & Mobility Monitoring

HEALTH TECH & DEVICE INTEGRATION (CMS-SAFE)

Function

  • Remote monitoring of functional recovery

  • HRV and mobility tracking

  • Patient self-management support

  • CMS-compatible reporting outputs

Integration Principles

  • Interoperable with EHRs

  • Non-diagnostic support tools

  • Decision-support, not clinical replacement

  • Compliance with CMS digital health frameworks

  • Omron Evolv Wireless Upper Arm Blood Pressure Monitor – Clinically-accurate, portable Bluetooth blood pressure monitor that syncs with phone apps for remote tracking (great for dashboards & data sharing).

  • Omron 10 Series Upper Arm Blood Pressure Monitor – Reliable BP monitor with irregular heartbeat screening and Bluetooth sync.

  • iHealth Track Smart Upper Arm Blood Pressure Monitor – Affordable Bluetooth BP monitor with color coding and app integration.

  • ProCheck Bluetooth Blood Pressure Monitor – Simple, validated BP monitor with memory storage and app support.

📌 Home and connected blood pressure monitoring are key for managing hypertension and cardiovascular risk — they allow patients to track real results over time and share them with care teams. Health Recovery Solutions+1

❤️ Heart Rate & ECG Monitoring

  • Polar Verity Sense Optical Heart Rate Sensor – Wearable heart-rate monitoring that tracks activity and cardiovascular response.

  • Polar H10 Heart Rate Sensor – Highly accurate chest-strap heart rate sensor that integrates with apps and fitness platforms.

  • Frontier X2 Smart Heart Monitor – Continuous ECG and heart health data — useful for deeper cardiac risk monitoring.

  • YHE BP Doctor Pro Blood Pressure Smartwatch – Smartwatch that combines BP and heart health tracking.

📌 Wearables and connected monitors help capture continuous heart rate, ECG, and activity data — ideal for tracking heart health trends and linking to behavioral outcomes. Main Line Health+1

How These Devices Support Your Program

Remote Monitoring: Track BP, heart rate, ECG, and activity outside clinical visits — feeding into your outcomes dashboard and care planning tools.
Data Integration: Bluetooth-enabled models sync with apps and EHRs, supporting CMS-aligned quality reporting and VBOHC outcomes.
Behavioral Insights: Some wearables also capture activity, sleep, and stress proxies — useful for anxiety and lifestyle interventions

OMOHC Chronic Musculoskeletal Pain IOP (VBOHC-Aligned)

Program Title: OMOHC Musculoskeletal Pain Recovery Intensive Outpatient Program (IOP)
Model: Value-Based Outdoor Healthcare (VBOHC) – an environment-first, epigenetics-responsive care model integrating nature-based interventions, functional movement, behavioral health, pain neuroscience education, and physiological recovery protocols.

Program Goals

  • Reduce chronic musculoskeletal pain and functional impairment through multi-modal, environment-first interventions.

  • Retrain pain pathways using graded exposure, environmental co-regulation, and epigenetic stress-reduction inputs.

  • Improve physical function, mental health, sleep quality, and work readiness.

  • Reduce opioid dependence, imaging overuse, and unnecessary specialist utilization.

Population Served

Adults aged 18–70 experiencing:

  • Chronic low back pain, neck pain, shoulder/hip pain, osteoarthritis

  • Post-injury or post-surgical persistent pain

  • Pain with comorbid anxiety/depression, catastrophizing, deconditioning

  • High-risk/ high-cost populations (frequent ED visits, work impairment data)

Care Team

  • Pain specialist NP/MD

  • Behavioral health clinician (MFT/CMHC)

  • Physical therapist + movement specialist

  • Health coach

  • RDN

  • Outdoor therapy specialist

  • Genomics/biomarker coordinator

  • Care navigator

2. CMS/CMMI Pilot Concept Letter (Formal)

To: Centers for Medicare & Medicaid Innovation (CMMI)
From: Oak Mountain Outdoor Healthcare (OMOHC)
Re: Value-Based Outdoor Healthcare (VBOHC): Chronic Musculoskeletal Pain Recovery Intensive Outpatient Demonstration Model

Summary of the Proposed Model

OMOHC proposes a 3-year demonstration of a novel Chronic Musculoskeletal Pain Intensive Outpatient Program (IOP) delivered within the Value-Based Outdoor Healthcare (VBOHC) framework. The model integrates CMS-recognized multidisciplinary pain care with nature-based therapeutic environments, epigenetically responsive stress-regulation protocols, functional movement retraining, digital monitoring, and behavioral health interventions.

Model Rationale

Chronic musculoskeletal pain is a leading driver of disability, opioid use, and avoidable utilization. Traditional episodic care reinforces fragmentation and delays functional recovery. Emerging evidence demonstrates that environmental regulation, physical conditioning, neuroeducation, and coordinated multidisciplinary care significantly improve outcomes, yet such models remain inaccessible. VBOHC offers a standardized, scalable methodology that embeds CMS priorities: health equity, data transparency, functional outcomes, and cost-of-care reduction.

Intervention Overview

Participants complete a 12-week structured IOP combining:

  • Outdoor therapeutic sessions (graded exposure for stress regulation and autonomic reset)

  • Physical therapy + movement retraining (strength, biomechanics, gait)

  • Pain neuroscience education

  • Behavioral health modules (ACT, CBT-P, trauma-informed care)

  • Epigenetic and biomarker tracking (cortisol, HRV, sleep, inflammatory markers)

  • Digital monitoring + daily environmental dose inputs

  • Care navigation and return-to-work planning

Target Population

Medicare and Medicaid beneficiaries with chronic musculoskeletal pain ≥ 12 weeks, functional limitation, or opioid‐use risk factors.

Payment Structure

OMOHC proposes a bundled episode-based payment for the 12-week IOP, including:

  • Risk-adjusted global payment for all services

  • Performance bonuses tied to functional improvement (PROMIS-29), opioid reduction, PT adherence, and return-to-activity

  • Optional shared savings with participating plans

Outcomes and Evaluation

The demonstration will evaluate:

  • Pain reduction and functional restoration

  • Reduced opioid utilization

  • Increased physical activity and environmental exposure metrics

  • Reduced ED/hospital use

  • Health equity improvements

  • Claims-based cost savings

  • Epigenetic and biological stress markers correlated with outcomes

Scalability

OMOHC will develop a replicable toolkit for national scale, including protocols, dashboards, provider training, and a CMS-aligned VBOHC registry.

Conclusion

The VBOHC Chronic Pain IOP represents a cost-effective, patient-centered, and innovative demonstration aligned with CMS goals for whole-person, equitable, and outcomes-driven care. OMOHC requests the opportunity to submit a full Concept Paper.

3. Outcomes Dashboard (VBOHC + CMS)

Domains:

A. Clinical + Functional Outcomes

  • PROMIS-29 Pain Interference

  • Oswestry Disability Index (or Neck Disability Index)

  • 6-Minute Walk Test / Sit-to-Stand

  • Range of Motion + Strength indices

  • Sleep Quality Index

  • Opioid MME reduction %

B. Environmental/Physiological Outcomes (VBOHC Inputs)

  • HRV improvement

  • Resting cortisol trend

  • Inflammatory panel (CRP, IL-6)

  • Daily “green-space dosage” minutes

  • Outdoor session adherence

  • Stress recovery index (algorithmic composite)

C. Behavioral Health Outcomes

  • PHQ-9, GAD-7

  • Pain Catastrophizing Scale

  • ACT engagement metrics

  • Self-efficacy for pain management

D. Claims + Utilization Outcomes (CMS)

  • Decrease in opioid prescriptions

  • Reduction in imaging orders

  • Reduction in specialist visits

  • Avoided surgeries

  • ED visits avoided

  • Total cost of care reduction

E. Health Equity Metrics

  • Geographic access

  • SDOH barrier reduction tracking

  • Enrollment diversity

  • Time to specialty access

4. 12-Week Curriculum + Daily Schedules

Format: 3 days/week, 3-hour sessions
Total Dose: 108 clinical hours + environmental practice hours

WEEKLY THEMES

  1. Week 1 – Orientation + Pain Neuroscience

  2. Week 2 – Environmental Regulation & Stress Reset

  3. Week 3 – Baseline Strength & Mobility Foundations

  4. Week 4 – Behavioral Activation & Fear Avoidance Reduction

  5. Week 5 – Movement Repatterning & Postural Rehab

  6. Week 6 – Environmental Exposure + Autonomic Training

  7. Week 7 – Trauma-Informed Pain Processing

  8. Week 8 – Functional Training + Real-World Carryover

  9. Week 9 – Outdoor Graded Exposure + Endurance

  10. Week 10 – Return-to-Work Functional Planning

  11. Week 11 – Consolidation + Relapse Prevention

  12. Week 12 – Graduation + Long-Term Plan

Daily Schedule (Sample Day)

9:00–9:30 AM: Outdoor grounding session (breathwork, autonomic reset, orientation)
9:30–10:15 AM: Pain neuroscience + education module
10:15–11:00 AM: PT + functional movement retraining
11:00–11:45 AM: Behavioral health (ACT for pain, CBT-P)
11:45–12:00 PM: Daily recovery assignment + digital tracking upload

Weekly Breakdown (Rolled-Up Example)

Weeks 1–2:

  • Foundations of pain, nervous system, epigenetic stress

  • Baseline mobility + light strength

  • Daily outdoor walks (10–20 min)

Weeks 3–4:

  • Corrective exercise, gait retraining

  • Values-guided action planning

  • Increased outdoor exposure (20–40 min)

Weeks 5–6:

  • Strength progression

  • Trauma-informed regulation

  • Environmental autonomic drills (forest paths, varied terrain)

Weeks 7–8:

  • Behavioral health intensives

  • Functional role simulation

  • Outdoor endurance training

Weeks 9–12:

  • Activity reentry

  • Home-based routines

  • Advanced strength + mobility

  • Discharge planning + long-term maintenance

5. IP Claims Language (Foundational Template)

(You can later expand into a full provisional or utility patent narrative.)

Claims Category A: Environment-First Epigenetic Pain Intervention

  1. A method for treating chronic musculoskeletal pain comprising:

    • administering a structured sequence of outdoor therapeutic exposures;

    • integrating autonomic regulation protocols aligned with environmental stimuli;

    • capturing physiological, behavioral, and environmental metrics;

    • producing individualized care adjustments in real-time via a proprietary VBOHC algorithm.

Claims Category B: Multidimensional Outcomes Dashboard

  1. A system for measuring therapeutic response that combines:

    • clinical pain metrics;

    • environmental dosage metrics;

    • epigenetic or biomarker indicators;

    • claims-based utilization data;
      into a unified outcome score predictive of long-term recovery.

Claims Category C: Curriculum Structure

  1. A 12-week musculoskeletal pain curriculum uniquely integrating:

    • graded outdoor exposure;

    • pain neuroscience education;

    • functional movement retraining;

    • trauma-informed behavioral protocols;

    • epigenetically responsive stress-modulation techniques.

Claims Category D: VBOHC Interoperable Device

  1. A digital tool that quantifies environmental inputs and correlates them with musculoskeletal pain outcomes, generating personalized recovery pathways.

6. Homepage Summary With VBOHC + CMS Focus

OMOHC Chronic Pain Recovery IOP

A CMS-Aligned, Value-Based Outdoor Healthcare Model for Musculoskeletal Pain

At Oak Mountain Outdoor Healthcare, chronic pain is not treated as a fixed condition—it is understood as a dynamic, environmentally shaped system that can reorganize toward health. Our Chronic Musculoskeletal Pain Intensive Outpatient Program (IOP) integrates evidence-based rehabilitation with the healing power of natural environments, creating a comprehensive recovery pathway aligned with CMS value-based care priorities.

Our program combines:

  • Outdoor therapeutic sessions that regulate stress and restore the nervous system

  • Physical therapy and functional movement retraining

  • Behavioral health and pain neuroscience education

  • Epigenetic and biomarker monitoring

  • Digital dashboards and CMS-ready outcome reporting

Built within the Value-Based Outdoor Healthcare (VBOHC) framework, this model reduces pain, improves mobility, lowers opioid dependence, and decreases unnecessary imaging and utilization—all while improving quality of life and addressing health equity.

Designed for CMS pilots, payers, employers, and health systems, the OMOHC IOP is a scalable, evidence-informed pathway that finally brings whole-person, environment-first pain care into mainstream healthcare.

Chronic Pain & Mobility Health Tech Device