Spinal fusions at HOPDs increase after CMS approval for ASCs


Outpatient cervical and lumbar fusions jumped at hospital-outpatient departments after CMS approved the procedures for ASCs while the procedure rate had little or no growth in surgery centers.

Optum teamed with Advisory Board to examine how CMS approval of procedures in ASCs shifted where surgeons performed procedures. The researchers found that procedures typically shifted outpatient slowly, and HOPD use increased at a higher rate than ASCs.

The report found that cervical fusions were up 26 percent in HOPDs and 1 percent in ASCs, according to Optum's deidentified Clinformatics Data Mart Database. CMS data also showed that cervical fusions for Medicare beneficiaries were up 13 percent in HOPDs and 1 percent in ASCs between 2014 and 2019.

Both Optum and CMS reported no change in lumbar fusion rates at ASCs. CMS reported that lumbar fusions were up 6 percent at HOPDs over the study period, and Optum reported a 3 percent increase of lumbar fusions at HOPDs.

The researchers also examined sacroiliac joint fusions but found a slightly different outcome. SI joint fusions were up 18 percent for Medicare beneficiaries at ASCs and 13 percent at HOPDs. Optum, on the other hand, reported that SI joint fusions jumped 12 percent at HOPDs and 5 percent at ASCs.

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