NASS Aims for Transparency in Spine Care

Christopher Cheney, for HealthLeaders Media , May 16, 2014

The Boston-based surgeon says early contacts with payers about the recommendations have been encouraging. NASS shared the organization's lumbar fusion recommendations with United Healthcare officials about seven months ago. "The feeling was quite positive," he said. "They made some requests to make it more useable."

Another payer, Cigna, is also weighing in on the NASS recommendations. David H. Finley MD, Cigna's national medical officer for enterprise affordability and policy, says the NASS guidelines should help the insurer set insurance coverage guidelines.

"Cigna appreciates the recommendations from NASS and will take them into consideration," he said. "Most of Cigna's coverage policies are reviewed annually and our decisions are based on a thorough study and analysis of the latest scientific evidence. We also consider guidance from medical societies."

Joseph Gregory, a surgical devices analyst at London-based GlobalData, says the NASS recommendations are a positive contribution to the spine surgery field, which has drawn scrutiny over explosive growth in spine fusion procedures. From 2002 to 2011, the annual number of US spine fusion procedures increased 77 percent, rising from 260,000 surgeries to 460,000, according to the federal Agency for Healthcare Research and Quality.

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