"We've seen more than one-third of the folks that are told they need spine surgery go to a center of excellence and find they need another type of care," says Kory Lundberg, director of national media relations at Wal-Mart. "We want to make sure our associates are getting the appropriate care for their illness and are able to recover."
Wal-Mart has since expanded the benefit to total joint replacements, cancer care and weight loss, among other medical conditions.
The company announced changes to their coverage yesterday to encourage more employees to use the program; going forward, employees must use a center of excellence or pay 50 percent of the cost of care for an out-of-network provider.
"We hope this will encourage our associates to go to centers of excellence," says Mr. Lundberg. "It's a wonderful benefit and something we helped pioneer in 2012. Whether you are a cashier in Wyoming that has been with us for less than a year or a long-term associate, if you have Wal-Mart health insurance you have access to some of the most renowned experts in the country to diagnose and treat your back pain. We want to make sure our associates have access to the right care at the right time; that's what the centers of excellence are all about."
Mr. Lundberg says there are still several opportunities for Wal-Mart employees to see local orthopedists for issues outside of spine care. The company focused on spine for the centers of excellence because they were seeing a high volume of spine surgeries, some of which may have been unnecessary.
"This initiative is about eliminating unnecessary care," says Mr. Lundberg. "We want associates to get spine surgery if they need it, but if there is other care out there that would be better, we want them to have that option."
Wal-Mart also expanded its centers of excellence hospitals to include Mayo Clinic facilities in Minnesota, Arizona and Florida. All centers of excellence facilities are chosen for their ability to provide high quality, cost-effective care.
"We think that by adding the Mayo Clinic locations, we can expand the geographic locations where the program is available to make sure our associates are getting the right care at the right time," says Mr. Lundberg.
Employees that seek care at a center of excellence will have 100 percent of their bill covered, including travel, lodging and expense allowance for the patient and caregiver. The benefit is extended to all employees that have Wal-Mart health insurance.
In a blog post announcing the news, Wal-Mart Senior Vice President-Global Benefits Sally Welborn wrote the company decided to expand the spine surgery centers of excellence benefit to focus on evidence-based guidelines, incentivize appropriate care and seek surgery as a last option.
More articles on spine surgery:
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The role of biologics in the next 5 to 10 years: 6 spine specialists weigh in
Drs. Michael Steinmetz, Robert Hart & more: 8 spine surgeons recently receiving honors