Spine & Neck Service Line Requires Planned Growth

As a nation, we have one aching back.

More and more Americans are experiencing back-related ailments, as well as neck pain. Hospitals are finding increasing revenues by setting up special back and neck pain centers, the number of which will increase dramatically in coming years. Back pain is the leading cause of some disability in Americans ages 19 to 45, affecting 80% of Americans at some point during their lifetime.

Hospitals are lining up with spine centers and physician groups to improve outcomes for patients and enhance fiscal performance, or launching freestanding facilities on or off campus because of increased demand for comprehensive programs. The approach can provide superior outcomes and minimize waste. For patients, the focus is on convenience, with "one-stop shop" centers, quick turnaround treatment, easy access, and increased outpatient services.

The Chicago Back Institute, which is part of the 206-bed Swedish Covenant Hospital, predicts that there will be a 22% increase in inpatient and a 37% increase in outpatient spine procedures between 2008 and 2018. Nonsurgical spine treatment currently accounts for about 90% of volume and 40% of spine revenues in the United States.

While spine surgery traditionally has been an area of lucrative income for hospitals, there is growing debate over the necessity of some procedures related to patient need. To balance those concerns, more and more hospitals are offering multifaceted care, with the possibility of surgery if needed, to expand their business operations.

With an increasingly older baby boomer population, many of whom remain active in sports and other activities, "there will be a dramatically increasing demand in this service line," says Jeffrey Canose, MD, president of Texas Health Presbyterian Hospital in Plano, a 329-staffed-bed facility, which partners with the Texas Back Institute to provide inpatient and outpatient services. "Back and spine care is increasingly complex and involves advanced technologies, and we have to focus better to meet the needs of the patient and try to bend the cost curve," Canose says. From our perspective, there has been a lot of freestanding and outpatient facilities that have proliferated in the last 10 years," says Canose.

Success Key No. 1: Coordinated care includes rehabilitation

The Alvarado Hospital Medical Center in San Diego incorporates the outpatient SpineZone, focusing on minimally invasive treatments, including exercise programs that physicians say improve patient outcomes and help reduce costs as a "one-stop" center dedicated to back, neck, and complex spinal problems. Located at the 80-bed hospital, the SpineZone specializes in what its physicians describe as "evidence-based, outcomes-driven" programs, with cost-effective specialization in strengthening and exercise programs, according to medical director Kam Raiszadeh, MD.