Medical Student Case Western Reserve University School of Medicine Cleveland, OH, US
Disclosure(s):
Matthew E. Rosenthal, BA: No financial relationships to disclose
Introduction: Bundled payment programs and centers of excellence (COE) for spinal surgery continue to evolve across the changing landscape of facilities spinal surgery is occurring. Employers and insurance carriers continue to strive for improved outcomes and the elimination of clinical variability. In this abstract we report our three data on implementation of a bundled payment program in an academic health system.
Methods: In 2020, a multicenter COE program for spinal surgery was formed to offer bundled payments within the University Hospitals Health System insurance plan in Cleveland, Ohio. We have over 40,000 insured patients across northeast Ohio. Bundled payments included single level lumbar spinal fusions, lumbar laminectomies, ACDF, and posterior cervical fusions with strict patient selection criteria.
Results: From 2022 – 2024, 450 patients were referred to the COE for surgical evaluation. Our conversion rate to surgery was 15% (n=70) using strict inclusion criteria. Prior authorization was waived and our average cost savings to our employees was $2,150 and total savings of $150,000. We had four 30-day readmissions in 3 years and one surgical site infection requiring reoperation.
Conclusion : Our caregivers and families have directly saved over $150,000 in 3 years within the UH COE spine surgical program through our strict inclusion criteria and surgery types included in the program. These programs are viable in large health systems and offer a way to give back to our caregivers.