Spinal surgery drop leads to fewer workers comp hospitalizations

Today’s post was shared by Workers Compensation and comes from www.businessinsurance.com.

As headlines like this one appear across the country we are simultaneously noting a significant increase in surgery denials from claims managers. Coincidence? – kc

Spinal Surgery

The number of inpatient hospitalizations among injured workers in California has declined, in part because of a reduction in the number of implant-eligible spinal surgeries in recent years, according the California Workers’ Compensation Institute.

From 2008 to 2014, workers comp inpatient hospitalizations declined 22.8%, according to an updated report, “Inpatient Hospital Utilization in California Workers’ Compensation,” released by CWCI on Thursday.

Payers of workers comp claims saw fewer hospital stays than Medicare, Medi-Cal and private coverage between 2013 and 2014, with the number of inpatient discharges for comp dropping 8.6%, the report states.

It also found that the number of workers comp implant-eligible spinal surgeries declined 8.4% in 2013 and 13.6% in 2014.

The decline “coincided with continued development of evidence-based medicine, utilization review, and independent medical review, fee schedule changes, and the phase out and ultimate repeal of duplicate ‘pass-through’ payments for hardware used in workers compensation spinal surgeries,” CWCI said in a statement.

However, since 2008, implant-eligible spinal surgeries have ranged between 21% and 23.2% of all workers comp inpatient discharges, according to the report. They accounted for 21.2% in 2014, the most recent year included.

The report notes that spinal fusions and back/neck procedures are the highest-volume inpatient hospital discharges among injured workers…

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