Changes in the Use of Lumbar Arthrodesis Procedures within Accountable Care Organizations

Spine
Andrew J SchoenfeldChristopher M Bono

Abstract

Retrospective review of Medicare claims data (2009-2014). To evaluate changes in the use of lumbar fusion procedures following the formation of Accountable Care Organizations (ACOs). Within surgical care afforded by ACOs, savings are thought to be realized by improved care coordination as well as reductions in the use of preference sensitive procedures such as lumbar fusion. We queried fee-for-service claims for patients enrolled in Medicare Part A and B, identifying patients who received lumbar spine fusion, discectomy or decompression procedures. We performed a difference-in-differences analysis comparing the use of lumbar fusion in ACOs and non-ACOs in the period before (2009-2011) and after (2012-2014) ACO formation. Propensity score adjustment was used to address differences in case-mix. Multivariable logistic regression was used to compare the likelihood of receiving a lumbar fusion in ACOs and non-ACOs in the period before and after ACO formation. Within organizations that would form ACOs, the raw rate of lumbar fusion increased from 50% (n = 2,183) in 2009-2011 to 54% (n = 2,283) in 2012-2014. Among non-ACOs, the use of fusion increased from 52% (n = 110,160) to 59% (n = 109,917). Adjusted difference in differences in t...Continue Reading

References

Nov 1, 1994·Journal of Clinical Epidemiology·M CharlsonJ Gold
Apr 8, 2010·JAMA : the Journal of the American Medical Association·Richard A DeyoJeffrey G Jarvik
Feb 22, 2013·JAMA Surgery·David C MillerJohn D Birkmeyer
Jul 16, 2014·The Spine Journal : Official Journal of the North American Spine Society·Andrew J SchoenfeldJohn D Birkmeyer
Apr 14, 2016·The New England Journal of Medicine·Peter FörsthBengt Sandén
Apr 14, 2016·The New England Journal of Medicine·Zoher GhogawalaEdward C Benzel
Apr 14, 2016·The New England Journal of Medicine·Wilco C Peul, Wouter A Moojen
Apr 15, 2016·The New England Journal of Medicine·J Michael McWilliamsAaron L Schwartz
Jul 22, 2016·International Journal of Spine Surgery·James M MokUNKNOWN Association for Collaborative Spine Research Investigators
Jan 11, 2017·Health Affairs·Valerie A LewisCarrie H Colla
Jan 12, 2017·Clinical Orthopaedics and Related Research·Andrew J SchoenfeldAdil H Haider
Mar 25, 2017·Annals of Surgery·Matthew J ResnickDavid F Penson

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