Data on Spinal Fusion Surgery

When examining Medicare data for spinal fusion surgery, significant differences exist within and between state-level, year-over-year comparisons, most notably in 2016 vs. 2017 & 2016 vs. 2018.

Charts for the years 2016, 2017, and 2018 displaying the data for the Medicare Inpatient Spinal Fusion Discharges by state.Medicare Provider analysis and Review file of 100% CMS inpatient claims for services provided to beneficiaries admitted to Medicare certified inpatient hospitals.

Americans spend treating low-back pain annually:

$90B+

Source: Modern Healthcare 2018

Spinal surgeries performed annually (spinal fusion, decompression, discectomy):

1.2M

Source: National Center for Health Statistics

Average cost per lumbar spinal fusion surgery:

$80K

Source: National Center for Health Statistics

Advantage of Value-designated Centers of Excellence Programs

16%

lower in Adjusted Episodic Cost Per Surgery for Lumbar Discectomy/Decompression

19%

lower for Cervical Simple Fusion

18%

lower for Lumbar Simple Fusion

1.5%

lower Adjusted Complication Rates

Source: Managed Care study: Finding the Value in Value-Designation: Evidence and Opportunity in the United States. Oct. 2016.

Use of biologics in …

Lumbar Spinal Fusion Procedures: 15%
Cervical Spinal Fusion Procedures: 3.6%

On the status of Centers of Excellence in spine & biologics …

Anne Preston

“This creates an incredible amount of leverage when establishing implant pricing. Combine increased surgery volume, high levels of physician alignment, and physician best practices around utilization and technology, and you have the perfect formula for deploying aggressive sourcing strategies for spine and osteobiologics. In this environment, HealthTrust members can expect to capture savings 10-15% better than what we consider fair market value.”

Anne Preston, AVP, HealthTrust Clinical Contracting Services

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