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