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Hospital costs increase as more instruments are used for degenerative spondylolisthesis
A recently published study found when more instruments were used in single-level fusions, costs to hospitals and insurance companies increased. However, hospital margins did not increase.
Researchers performed a retrospective chart review for 233 patients who underwent single-level fusions and had an ICD-9 diagnosis of degenerative spondylolisthesis with spinal stenosis.
Results showed overall charges and expenses for non-instrumented posterolateral fusions (PLF) were significantly less vs. posterolateral fusion with pedicle screws (PPS) and posterolateral lumbar interbody fusion with an interbody device (PLIF). Investigators noted the most common insurance types were Medicare and private insurance.
The mean reimbursement for PLF was $36,903 for Medicare and was $47,086 for private insurance. For PPS, the mean reimbursement for Medicare was $37,450 and was $53,851 for private insurance. The mean reimbursements for Medicare and private insurance for patients who underwent PLIF were $40,171 and $51,640, respectively.
In Medicare patients, the hospital margins for PPS and PLIF were negative (-$3,702 and -$6,456, respectively). In the three fusion groups, hospital margins were largest for workers’ compensation and private insurance patients. Investigators found Medicare hospital margins for PLF, PPS and PLIF were $24,347, $19,205, and $23,046, respectively, while private insurance hospital margins for the procedures were $37,569, $36,834, and $33,134, respectively. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.
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Lyons KW, et al. Int J Spine Surg. 2019;doi:10.14444/6052.
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