Study: Insurance restrictions on lumbar fusions push procedure volumes down

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An insurance policy limit on lumbar fusion procedures helped slash costs and medically unnecessary surgeries in North Carolina, and the approach could work nationally, according to new research published in the journal Spine.

“The commercial insurance policy change had its intended effect of reducing fusion operations for indications with less evidence of effectiveness, without changing rates for other indications or resulting in an overall reduction in spine surgery,” the authors wrote. “Broader adoption of the policy could significantly reduce the national rates of fusion operations and associated costs.”

Researchers analyzed North Carolina’s inpatient database from 2005 through 2012, plus the Nationwide Inpatient Sample, including all inpatient lumbar fusion admissions from nonfederal hospitals. Specifically, the authors looked at adults undergoing elective lumbar fusion or re-fusion operations.

 

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