A study published in the International Journal of Spine Surgery examined bundled payments and how they could affect resource utilization during spine surgery.
The researchers collected surveys from spine surgeons describing eight clinical scenarios; the surgeons responded with the appropriate answer for their current practice and then responded in the hypothetical bundled payment system.
There were 43 surgeons who completed the survey. The researchers found:
1. In every scenario, there were respondents who would change at least one aspect of their practice with bundled payments; 24 percent to 49 percent of the surgeons reported change for each scenario.
2. Four scenarios had an increase in the proportion of cases performed without implants by an average of 8 percent; the other four scenarios didn’t have a change in whether implants were used.
3. Iliac crest bone graft use was increased in all scenarios by an average of 18 percent if bundled payments were implemented.
4. Surgeons were more likely to decrease neuromonitoring with bundled payments; the neuromonitoring would decrease in all scenarios by an average of 21 percent.
5. The cost differences weren’t statistically significant.