Are Spine Surgeons Profiting From Supply Preferences?
Federal investigation sounds warning on spinal implants' physician-owned distributors.
Published: October 24, 2013
Hospitals that buy implants for spinal fusion cases from distributors which count physicians among their owners tend to host more spine surgeries, according to a federal report issued this week.
Compiled by the Department of Health and Human Services' Office of Inspector General, the report investigated Congress's concern that the increasing presence of physician ownership in the spinal implant industry may be creating a financial conflict of interest for some surgeons that colors their clinical objectivity.
For the report, investigators reviewed 1,000 Medicare claims from fiscal year 2011 that involved spinal fusion surgery, then questioned the hospitals that submitted them on the implants used and their knowledge of their physicians' ownership interests.
They found that 34% of the hospitals surveyed had bought spinal implants from physician-owned distributors (or PODs), and that POD-supplied implants were used in 19% of the spinal fusion surgeries billed to Medicare. While cost is often cited as a justification for purchasing PODs' implants, hospitals that used such devices did not see significantly lower case costs.
In addition, hospitals that bought implants from PODs saw their spinal surgery volumes jump 21%, as compared to the 9% growth across the industry as a whole. And in fiscal year 2012, spine surgeons did 28% more cases at hospitals which obtained such implants than those which didn't.
"Taken together, these factors may increase the cost of spinal surgery to Medicare over time," say the investigators, who note that hospitals' varied requirements with regards to physicians' disclosure of financial interests likely leaves them and their patients in the dark if the choice of implants is driven by a profit motive.
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