8 8
O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2 0 1 4
S P I N E
S
pine cases continue to
shift to the outpatient
setting for a variety of
reasons, including undeniable
cost savings, but private insurers
are extraordinarily slow to adapt,
mostly because they follow the
lead of Medicare's antiquated
reimbursement policies, which
still require that all spine surger-
ies be performed as inpatient
procedures.
According to Medicare, spine
procedures can't even be per-
formed in the outpatient depart-
ment of an acute care hospital.
Well, that's not technically cor-
rect. Hospitals can send patients
home the day of surgery, but only after going through the song and dance of
admitting them first.
That negates the cost-effectiveness of performing the procedure. It also
increases the risks of post-op complications: The literature shows complica-
tions jump by as much as 800% the minute patients are admitted following
surgery due to hospital-acquired wound infections and pneumonia.
Hospitalized patients are also at increased risk of deep vein thrombosis and
urinary tract infections because they rarely ambulate adequately after sur-
gery.
GRADUAL MIGRATION
Medicare Stymies Spine's Potential
SITE OF SERVICE Spine cases are per-
formed where reimbursements flow easily.
OSE_1403_part2_Layout 1 3/5/14 10:53 AM Page 88
