A new study published in the Journal of Neurosurgery: Spine examines bundled payment reimbursement for anterior and posterior spine surgeries.
The study authors examined outcomes for patients who underwent anterior or posterior treatment for cervical spondylotic myelopathy from the Medicare 5% National Sample Administrative Database and Humana orthopedic database between 2005 and 2014. There were 16,444 patients included in the study.
Study authors found:
1. In the Humana database, average reimbursement for the anterior approach was $20,863, while the average reimbursement for the posterior approach was $23,813, based on a 90-day episode of care.
2. In the SAF4 database, the average reimbursement for the anterior approach was $18,219 and average reimbursement for the posterior approach was $25,598.
3. Patients who underwent procedures with the posterior approach had higher reimbursements for rehabilitation and skilled nursing as well as hospital and inpatient care in both databases.
4. Both databases reported reimbursement for the hospital was more than double the surgeon-related reimbursement.
5. Study authors concluded, "Understanding the reimbursement patterns for anterior versus posterior approaches for CSM will help providers design a bundled payment for patients requiring surgery for CSM and this study suggests that a subset of patients who require the posterior approach for treatment also require greater resources. The data also suggest that hospital-related reimbursement is the major driver of payments."