The American Chiropractor Volume 36, Issue 6 | Page 12

Spinal Fusion Market Size to Suffer
Amid Scrutiny and Reimbursement
Changes, says GlobalData Analyst
LONDON, UK (GlobalData), 13 May 2014 - With spinal fusion surgeries receiving extensive scrutiny from various facets
of the US medical community, the number of procedures
performed will be hindered mainly by reimbursement changes,
says an analyst with research and consulting finn GlobalData.
Joseph Gregory, GlobalData ' s Analyst covering Surgical
Devices, states that everyone, from health insurers and hospital management to spine surgeons and policy makers, has
expressed concerns that the increasing procedure volumes
in tllis market may not always be associated with medically
necessary indications.
Based on infonnation from the Agency for Healthcare Research and Quality, the number of spinal fusion procedures in
the US annually has increased by 77%, from approximately
260,000 in 2002 to 460,000 in 2011. Gregory says that tIlis
growtll rate appears much more dramatic when compared with
tlle surgical repair of other orthopedic degenerative conditions
in differing articulations.
The analyst continues: "One of the primary reasons for this
rapid growth is expansion in the indications for which spinal

fusion surgery is perfonned. The original intent of spinal fusion was to treat severe scoliosis and spinal tuberculosis, but its
indication profile has since increased significantly. Now there
are 14 conditions for which tlle procedure is deemed medically
indicated, including degenerative disc disease and stenosis."
The utilization of spinal fusion in an increasing number of
indications and its associated cost to the healthcare system has
led to significant changes in the reimbursement policies for tllis
procedure in the US, according to Gregory.
The analyst says: "Insurance compatlies have recently instituted
several measures to combat tllese soaring figures. Originally,
insurers issued reimbursement payments as long as the hospital
coded tlle procedure properly.
"Now, the payers require extensive documentation to validate
the medical necessity of the procedure, including well-documented attempts at conservative care and radiographic imaging
to record the source of pain."
GlobalData believes tllat these measures will tatnper Witll tlle
spinal fusion procedural growtll rate and subsequently impact
the overall market valuation over the coming years. While these
procedures have experienced Compound Annual GrowtllRates
of close to 10% in the past, this rate is expected to be reduced
to 5% throughout the forecast period until 2020.

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8 I The American Chiropractor I JUNE 2014

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