Bloomington, Minn.-based health insurer HealthPartners is changing the way it covers patients considering spine surgery, in an effort to decrease costs and increase efficacy, according to a Star Tribune report.
The company said Thursday that starting Jan. 1, members will have to undergo an evaluation by a spine specialist to focus on non-surgical treatment options before they can see a surgeon. The company said the decision follows growing evidence that aggressive surgical treatments may not be the best option for some patients. The company said patients often choose other routes when educated about non-surgical options.
HealthPartners has chosen 102 locations in Minnesota and Wisconsin where "designated spine specialists" can perform evaluations. Patients can still see a surgeon after the visit without permission from the specialist, but the company hopes patients will be better-informed about their options after the discussion.
HealthPartners spent more than $28.3 million on lumbar fusions and other spine surgeries in 2011 but could not predict how much cost savings the new rules might accrue.
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The company said Thursday that starting Jan. 1, members will have to undergo an evaluation by a spine specialist to focus on non-surgical treatment options before they can see a surgeon. The company said the decision follows growing evidence that aggressive surgical treatments may not be the best option for some patients. The company said patients often choose other routes when educated about non-surgical options.
HealthPartners has chosen 102 locations in Minnesota and Wisconsin where "designated spine specialists" can perform evaluations. Patients can still see a surgeon after the visit without permission from the specialist, but the company hopes patients will be better-informed about their options after the discussion.
HealthPartners spent more than $28.3 million on lumbar fusions and other spine surgeries in 2011 but could not predict how much cost savings the new rules might accrue.
Related Articles on Coding, Billing and Collections:
Massachusetts Healthcare Program to Include Legal Immigrants
Extension of the 2011 Physician Payment Rates and Other Policies
50 New Statistics on Surgery Center Payor Mix