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90-day posterior lumbar fusion payments: 74.2% to 77% go to hospitals — 5 things to know Featured

By  Laura Dyrda | Friday, 12 January 2018 07:21
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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.

 

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