A new study published in Spine examines the 90-day reimbursements for primary single-level posterior lumbar fusion.
Study authors examined administrative claims data for commercial payers, Medicare Advantage and Medicare plans for primary single-level posterior lumbar interbody fusions. The authors also found how payments were distributed among stakeholders.
The study authors found:
1. Hospital costs accounted for 74.2 percent to 77 percent of the total payments for single-level posterior lumbar fusions. Surgeons' fees accounted for 12.8 percent to 13.7 percent.
2. Readmissions and revisions accounted for 2.1 percent to 2.7 percent of the overall burden; however, among those patients who were readmitted, the readmissions and revisions cost 25 percent to 54 percent of the payment for the 90-day episode.
3. Inpatient surgery facility costs were significantly higher than outpatient surgery facility costs.
4. For commercial payers, the average 90-day payment was $51,465, compared with $26,234 for Medicare Advantage and $25,501 for Medicare.
5. Study authors concluded that reducing hospital costs and readmissions could lower financial burden from spine procedures.