Interesting…. Most everyone is exceptionally cynical when it comes to payors and I imagine most perceive this as a ploy to deny surgery to patients. May be it is… but maybe it isn’t. The failure rate of spine surgery for low back pain is very high in certain conditions, yet the results for extremity pain due to disc herniation (pinched nerve) is quite high. It will be interesting to follow this and see how it plays out.
A few weeks ago I mentioned the promising results associated with the use of Appropriateness Criteria for spine surgery. From that article it was clear that proper patient selection and the use of proper indications by surgeons is critical to drive the success rate of spine surgery.
I’m not ready to join the naysayers yet on United’s effort. I’ll give them the benefit of the doubt and see how this plays out. Spine surgery is clearly not the answer for all patients with back pain.
Of course… nothing that I mentioned should be construed as medical advice, nor is it the policy of my employers.