Surgeons and medical device makers find insurers are resisting costly back fusions and requiring proof that less risky therapy for pain has been given a chance.
Updated: 01/29/2011 11:35:39 PM CST
There's nothing like back pain.
Just ask Dan Hoxworth, 50, of Mahtomedi. Beyond watching his father and brothers suffer from disc problems over the years, Hoxworth has felt the pain personally with herniated discs in each of the past three decades. The sensation at times is a bit like sticking your finger in an electrical outlet — and not pulling it out, he says.
Still, there are two key reasons Hoxworth considers himself lucky in his spinal struggles.
First, the interval of time between each of his three episodes of back troubles grew. His first two herniated discs were separated by a span of just six years, while it was another 13 years before he suffered from a third disc problem in 2008. So, Hoxworth jokes that his back now should be good for another 20-plus years or so.
The second bit of luck is no joke.
'I've had success in avoiding surgery,' Hoxworth said. 'The doctors I've had always said that surgery is the last option.'
Pushing back on spine surgery is becoming a battle cry for health plans these days, too. Faced with skyrocketing health costs due to surgeries known as spinal fusions, health plans in Minnesota and across the U.S. are intensifying scrutiny of the procedures.
Spine surgeons are feeling the impact. So are companies like Fridley-based Medtronic, which is the largest manufacturer of medical devices used in spine surgery.
'Payers are also implementing new fusion procedure guidelines, which are lengthening the time required to give pre-approvals,' said Gary Ellis, the chief financial officer at Medtronic, during a conference call with investors last year.
Just ask Dan Hoxworth, 50, of Mahtomedi. Beyond watching his father and brothers suffer from disc problems over the years, Hoxworth has felt the pain personally with herniated discs in each of the past three decades. The sensation at times is a bit like sticking your finger in an electrical outlet — and not pulling it out, he says.
Still, there are two key reasons Hoxworth considers himself lucky in his spinal struggles.
First, the interval of time between each of his three episodes of back troubles grew. His first two herniated discs were separated by a span of just six years, while it was another 13 years before he suffered from a third disc problem in 2008. So, Hoxworth jokes that his back now should be good for another 20-plus years or so.
The second bit of luck is no joke.
'I've had success in avoiding surgery,' Hoxworth said. 'The doctors I've had always said that surgery is the last option.'
Pushing back on spine surgery is becoming a battle cry for health plans these days, too. Faced with skyrocketing health costs due to surgeries known as spinal fusions, health plans in Minnesota and across the U.S. are intensifying scrutiny of the procedures.
Spine surgeons are feeling the impact. So are companies like Fridley-based Medtronic, which is the largest manufacturer of medical devices used in spine surgery.
'Payers are also implementing new fusion procedure guidelines, which are lengthening the time required to give pre-approvals,' said Gary Ellis, the chief financial officer at Medtronic, during a conference call with investors last year.
