The study authors examined CMS, U.S. Census Bureau, Dartmouth Atlas and WWAMI Rural Health Research Center data for quality, supply, demand, substitute treatment, availability, patient characteristics, competitive factors and provider characteristics. They also created a predictive reimbursement models using multivariate linear regression to understand factors influencing thoracolumbar fusion.
Here are five key findings:
1. Demand variables contributed to the largest variation in reimbursement.
2. The three drivers that increased reimbursement include:
• Provider charges
• Total Medicare reimbursement
• Number of spinal surgeries per 1,000 patients in the region
3. The institutional volume was negatively associated with TLIF reimbursement.
4. Reimbursement varied widely across the U.S.
5. Quality of care wasn’t associated with increased reimbursement for TLF.
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