The Centers for Medicare & Medicaid Services division of outpatient care is considering the removal of cervical disc arthroplasty from the Medicare "inpatient only" list, a move which the International Society for the Advancement of Spine Surgery supports. ISASS President Steven Garfin, MD, sent a letter to CMS in support of the move, which would allow cervical arthroplasty to be performed in an outpatient setting for Medicare patients. The letter cites convenience, lower cost and more efficient scheduling as reasons to allow cervical fusions into the outpatient setting.
The letter also recognizes the benefits of in-hospital care, but states: "We feel that age, alone, should not be a reason to disqualify an older patient from having cervical disc arthroplasty in an outpatient setting. Improved technology and advances in anesthesia and pain control have improved patient satisfaction in the perioperative period and studies show many patients have a preference for, and satisfaction with, postoperative recovering in the home setting."
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The letter also recognizes the benefits of in-hospital care, but states: "We feel that age, alone, should not be a reason to disqualify an older patient from having cervical disc arthroplasty in an outpatient setting. Improved technology and advances in anesthesia and pain control have improved patient satisfaction in the perioperative period and studies show many patients have a preference for, and satisfaction with, postoperative recovering in the home setting."
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