Praveen Mummaneni, MD, of the University of California San Francisco is a neurosurgeon who directs several UCSF programs on the cervical spine, including the fellowship program in minimally invasive and complex spine surgery. He currently serves as co-director of the UCSF Spine Center.
Here, Dr. Mummaneni provides his opinion on bundled payments in spine:
Question: What does the future hold for bundled payments in spine?
Dr. Praveen Mummaneni: Bundled payments may work for a portion of spine cases done annually. The one-level degenerative case in a healthy patient has a predictable outcome and could be bundled. However, many spine cases do not easily fit into a bundle. How does one predict outcomes and potential complications for a scoliosis correction in an elderly patient with diabetes and a history of heart disease? How to do a bundle for a spinal metastatic tumor causing paraplegia on a weekend?
There are so many variables due to comorbidities and surgical approaches. If such complex cases are bundled, then the elderly and sick patients may not be able to easily access care. We should not set up a system where these patients have barriers to care.
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