5 things to know on 90-day episode-of-care for ACDF

Spine

A new study published in the Journal of Bone & Joint Surgery examined the 90-day episode of care costs for one- and two-level anterior cervical discectomy and fusions.

The researchers examined the Medicare 5% National Sample Administrative Database for clinical and financial data associated with the surgical procedure and postoperative period for 90 days. There were 4,506 patients included in the study who received surgery from 2005 to 2012.

 

The researchers found:

 

1. Total reimbursement for the 90-day period was $69.4 million with the average cost per patient around $15,417±$947. By comparison, the average reimbursement for patients who underwent total knee and hip replacement was around $17,451 per patient.

 

2. The physician received 20.42 percent of the total reimbursement for ACDF and the surgeon received 18.07 percent.

 

3. The cost of revision surgery, readmission and emergency department reimbursement was around 0.71 percent of the total reimbursement.

 

4. The rehabilitation services represented 3.11 percent of the reimbursement, including rehabilitation, physical therapy, skilled nursing facilities and home care.

 

5. The researchers found significant variation in reimbursement among the different regions of the United States with the highest variation in the West.

 

"Our study provides a reimbursement benchmark for one to two-level ACDF procedures," concluded the study authors. "Clarifying the payments relative to costs will help providers to understand whether a bundled payment for the ACDF procedure is economically viable."

 

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