NASS Looks To Lead Discussion In Spine Reimbursement
The North American Spine Society is taking what might be an unprecedented step by medical society to help surgeons in their struggles with insurers. It has set out to write its own set of coverage guidelines, which would advise insurers – and surgeons – which spinal procedures payors should cover. NASS established a multidisciplinary 25-person task force to draw up the coverage guidelines. Eventually, the task force hopes to have compiled a book of guidelines advising insurers when a procedure should or shouldn’t be covered.
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This years’ gathering of the North American Spine Society (NASS) carried a muted tone that befits a stagnant or shrinking industry. Surgeons in NASS’ leadership spoke to the minimal growth in their own reimbursements and their concerns over how changes in the health care sector will impact the specialty going forward.
A decade ago, the treatment of vertebral compression fractures (VCF) represented one of the fastest - and most innovative - segments of a spine industry that was set to explode. The two principal procedures - vertebroplasty and its distant cousin kyphoplasty - presented surgeons and interventionalists with a minimally invasive option to stop pain and, in the case of kyphoplasty, restore the shape and form to a broken vertebra. Now, two studies published in The New England Journal of Medicine suggesting that vertebroplasty procedures were no more effective in relieving pain than a placebo treatment have put pressure on VCF companies and doctors, who are facing pushback on reimbursement and some skepticism from even their own specialists.
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