When Michigan insurance company Priority Health required patients with back problems seeking care from spine surgeons to first consult with a physical medicine and rehabilitation specialist, spine operations fell 25% in a region identified as having an excessive rate of surgery.
According to John Fox MD, "mandatory physiatrist consultation prior to surgery resulted in decreased surgical rates and back pain costs with continued patient satisfaction across a large region". In addition to the reduction in surgeries, there was a 48% reduction in surgical referrals, 18% decrease in imaging studies, and a 12% decrease in spine care costs.
Where you live has a direct impact on your likelihood of spine surgery. In 2006, Weinstein et al (Spine, 31:2707-14) analyzed Medicare data and determined that rates of fusion surgery can vary by as much as 20-fold by region, state and even when comparing city to city. Rates of discectomy and laminectomy varied by as much as 8-fold.
Data from the Federal Healthcare Cost and Utilization Project shows the number of fusions doubled to over 400,000 between 2002 and 2008. According to John Birkmeyer, director of the Center for Healthcare Outcomes and Policy at the University of Michigan, at least $150 billion will be spent on unnecessary surgeries.
Posted in: General