Are Cervical Disc Arthroplasty Medicare Reimbursement Trends Sustainable?

Emily S. Mills; Cory K. Mayfield; Tara Shelby; Andy T. Ton; Raymond J. Hah; Ram K. Alluri

doi:10.14444/8428

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Figure 1
Total cervical disc arthroplasty utilization from 2007 to 2017.
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Figure 2
Medicare beneficiary cervical disc arthroplasty utilization from 2007 to 2017.
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Figure 3
Inflation-adjusted hospital charges for cervical disc arthroplasty from 2007 to 2017. USD, US dollars.
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Figure 4
Inflation-adjusted Medicare physician reimbursement from 2009 to 2021. USD, US dollars.

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Table

Baseline characteristics of patients who underwent cervical disc arthroplasty per year, from 2007 to 2017.

Demographic	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	Total	P Value
Age, y	46.60 ± 1.2	45.76 ± 0.8	46.34 ± 0.7	45.79 ± 0.8	47.56 ± 0.9	45.86 ± 1.0	46.78 ± 0.9	47.29 ± 0.9	47.18 ± 0.8	46.63 ± 0.7	47.32 ± 0.7	46.7 ± 0.3	0.0043
Length of stay, d	1.72 ± 0.2	1.62 ± 0.2	1.74 ± 0.2	1.50 ± 0.2	1.72 ± 0.2	1.67 ± 0.2	1.67 ± 0.2	1.56 ± 0.4	1.65 ± 0.1	1.48 ± 0.1	1.59 ± 0.1	1.6 ± 0.1	0.1853
Female	163 (51.4)	273 (49.9)	333 (49.9)	323 (52.1)	286 (48.8)	192 (45.6)	234 (49.1)	303 (50.2)	371 (53.7)	446 (52.5)	451 (53.1)	3375 (50.9)	0.26
Caucasian	206 (65.0)	384 (70.2)	485 (72.7)	469 (75.7)	410 (70.0)	316 (75.1)	335 (70.2)	421 (69.8)	511 (74.0)	655 (77.1)	641 (77.1)	4833 (72.9)	<0.001
Medicare payment	29 (9.2)	24 (4.4)	49 (7.3)	42 (6.7)	56 (9.6)	34 (8.1)	45 (9.4)	66 (10.9)	84 (12.2)	88 (10.4)	107 (12.6)	624 (9.4)	<0.001
Private insurance	318 (68.8)	360 (65.8)	397 (59.61)	356 (57.5)	354 (60.7)	262 (62.5)	331 (69.5)	381 (63.5)	444 (64.3)	541 (63.7)	550 (64.8)	4294 (64.8)	<0.001
75^th–100^th zip code quartile	86 (27.1)	146 (26.7)	149 (22.3)	148 (23.9)	196 (33.4)	126 (29.9)	151 (31.7)	182 (30.2)	205 (29.7)	257 (30.2)	274 (32.3)	1920 (29.0)	<0.001
Large bed size	150 (47.3)	317 (58.0)	390 (58.5)	332 (53.5)	388 (66.2)	247 (58.7)	295 (61.8)	273 (45.3)	328 (47.5)	417 (49.1)	433 (51.0)	3570 (53.86)	<0.001
Private, investment hospital	65 (20.5)	107 (19.6)	86 (12.9)	129 (20.8)	127 (21.7)	90 (21.4)	127 (26.6)	131 (21.7)	154 (22.3)	187 (22.0)	176 (20.7)	1631 (24.6)	<0.001
Urban	158 (49.8)	250 (45.7)	373 (57.5)	302 (49.2)	219 (54.9)	199 (47.3)	239 (50.1)	157 (26.0)	208 (30.1)	254 (29.9)	214 (25.2)	2573 (38.8)	<0.001
Rural	10 (3.15)	32 (5.85)	23 (3.54)	20 (3.26)	13 (2.24)	17 (4.04)	11 (2.31)	27 (4.48)	35 (5.07)	26 (3.06)	26 (3.06)	240 (3.6)	<0.001
Western region	69 (21.77)	130 (23.77)	131 (19.64)	131 (21.13)	219 (37.37)	126 (29.93)	151 (31.66)	180 (29.85)	185 (26.77)	257 (30.24)	288 (33.92)	1867 (28.2)	<0.001

Note: Data are reported as n (%) except for age and length of stay, which are reported as mean ± SD. Significance was obtained through linear regression with P < 0.05 as significant.