- Joined
- Apr 7, 2011
- Messages
- 5,313
- Reaction score
- 1,085
Resurrecting an old thread.
Below is a link to the 2007 Medicare spine surgery bench-marking database from Dartmouth. (2007 is the most recent data available from Dartmouth.) The data are arranged such that the x-axis is geographic location and the y-axis is surgical rate per 1000 beneficiaries. The national rate is about 4.5-5/1000. If you run your cursor over the data points on the graph you will see the name of the city (HRR) associated with that data point. If you are a physiatrist and you live in an area with a spine surgery utilization > 5.5/1000 beneficiaries then you have an opportunity.
http://www.dartmouthatlas.org/data/distribution.aspx?ind=73&tf=10&ch=32&loct=3&fmt=98
Two payors have demonstrated a substantial reduction in surgical rates - ~30% - with no change in patient satisfaction utilizing a 1st stop Physiatric Spine Clinic Model: Lovelace Clinic(1) in NM & Priority Health(2) in MI. (N. CA Kaiser's spine clinic model is based on the Lovelace data.) There is no rational way to explain the spine surgery rates shown in the graph above about 5.5/1000 - chance, patient preference, disease prevalence, etc, can not explain it - it is simply waste. If you were privy to the dollar amounts involved you would be staggered. This is a BIG ticket item.
Attached are links that you can provide to your local insurers. These data will fall on deaf ears with hospital administrators because they stand lose a great deal if they have outlier surgeons in their facility.
1. Bridging the gap between science and practice in managing low back pain. A comprehensive spine care system in a health maintenance organization setting.
Klein BJ, Radecki RT, Foris MP, Feil EI, Hickey ME. Spine (Phila Pa 1976). 2000 Mar 15;25(6):738-40.
2. John Fox, Priority Health. http://www.priorityhealth.com/provider/manual/auths/coe/spine-coes.aspx
3. Blue Care Network Spine Care Programs. http://ereferrals.bcbsm.com/new_bcn_spine_care_referral_program.pdf
4. Who's in the driver's seat? The influence of patient and physician enthusiasm on regional variation in degenerative lumbar spinal surgery: a population-based study.
Bederman SS, Coyte PC, Kreder HJ, Mahomed NN, McIsaac WJ, Wright JG.
Spine (Phila Pa 1976). 2011 Mar 15;36(6):481-489.
Below is a link to the 2007 Medicare spine surgery bench-marking database from Dartmouth. (2007 is the most recent data available from Dartmouth.) The data are arranged such that the x-axis is geographic location and the y-axis is surgical rate per 1000 beneficiaries. The national rate is about 4.5-5/1000. If you run your cursor over the data points on the graph you will see the name of the city (HRR) associated with that data point. If you are a physiatrist and you live in an area with a spine surgery utilization > 5.5/1000 beneficiaries then you have an opportunity.
http://www.dartmouthatlas.org/data/distribution.aspx?ind=73&tf=10&ch=32&loct=3&fmt=98
Two payors have demonstrated a substantial reduction in surgical rates - ~30% - with no change in patient satisfaction utilizing a 1st stop Physiatric Spine Clinic Model: Lovelace Clinic(1) in NM & Priority Health(2) in MI. (N. CA Kaiser's spine clinic model is based on the Lovelace data.) There is no rational way to explain the spine surgery rates shown in the graph above about 5.5/1000 - chance, patient preference, disease prevalence, etc, can not explain it - it is simply waste. If you were privy to the dollar amounts involved you would be staggered. This is a BIG ticket item.
Attached are links that you can provide to your local insurers. These data will fall on deaf ears with hospital administrators because they stand lose a great deal if they have outlier surgeons in their facility.
1. Bridging the gap between science and practice in managing low back pain. A comprehensive spine care system in a health maintenance organization setting.
Klein BJ, Radecki RT, Foris MP, Feil EI, Hickey ME. Spine (Phila Pa 1976). 2000 Mar 15;25(6):738-40.
2. John Fox, Priority Health. http://www.priorityhealth.com/provider/manual/auths/coe/spine-coes.aspx
3. Blue Care Network Spine Care Programs. http://ereferrals.bcbsm.com/new_bcn_spine_care_referral_program.pdf
4. Who's in the driver's seat? The influence of patient and physician enthusiasm on regional variation in degenerative lumbar spinal surgery: a population-based study.
Bederman SS, Coyte PC, Kreder HJ, Mahomed NN, McIsaac WJ, Wright JG.
Spine (Phila Pa 1976). 2011 Mar 15;36(6):481-489.
Last edited:
