Spine surgeons' next payer battle
By Admin | December 15, 2023
Spine surgeons saw a major victory in a yearslong payer battle this year when Aetna revised its lumbar disc replacement policy in February. Now, some surgeons are looking ahead to the next hurdle they could face from insurers.
Endoscopic spine surgery, a minimally invasive technique, has grown its reach in the U.S. in recent years. But it's seeing some resistance, Michael Gallizzi, MD, said.
"Payers currently pose a significant barrier," Dr. Gallizzi, of the Steadman Clinic in Vail, Colo., told Becker's. "Some states strongly oppose the adoption of this technology on the payer side, even though it's an approved Medicare procedure."
However, Dr. Gallizzi didn't think conflicts with payers and endoscopic spine would mirror those of disc replacement.
"I believe that part of the issue with disc replacement in the neck and lumbar spine arises from the fact that it involves an implant rather than a technique or technology," he said. "Because it's an implant, payers are often reluctant to cover something that's expensive. Conversely, adopting these tools and performing procedures in this manner usually falls under...(More)
For more info please read, Spine surgeons' next payer battle, by Becker's Spine Review
