447 - Reducing Disparity in Specialized Spine Care Coverage...

#447 Reducing Disparity in Specialized Spine Care Coverage

Regulatory Issues: Coding, Reimbursement, Coverage

Poster Presented by: M. Lorio


M. Lorio (1)
C. Conduff (2)

(1) NeuroSpine Solutions, P.C., Bristol, TN, United States
(2) Spine Health Foundation, Johnson City, TN, United States


Background: The Spine Health Foundation, Inc. (SHF) meets unrecognized and unmet needs of individuals suffering with chronic spinal pain related to spinal disorders/injuries. The Spine Health Foundation, inc. serves as a resource and access advocacy organization for uninsured, under-insured, low-income individuals (those lacking coverage). SHF was created to provide individuals with specialized spine care coverage to relieve pain and correct spinal/structural issues - enabling them to live a life “without” pain. By providing eligible individuals access to specialized spine care. Resources include surgery, physical therapy, epidurals, chiropractic treatments, consultations, diagnostic testing, and back braces.

Purpose: The purpose of this organization is to provide the opportunity for low-income, uninsured individuals to receive appropriate specialized spine care.

Study design and setting: Retrospective review.

Patient Sample: Uninsured, under-insured, low-income patients unable to obtain specialized spine care coverage in the current socio-economic system.

Outcome Measures: Since February 2011, over 30 individuals (from 8 Appalachian counties in TN and VA) have received nearly 200 resources through SHF including more than a dozen spine surgeries. Outcomes are measured individually based on VAS pain score rating pre-op and post op given the broad spectrum of spinal pathology and treatments provided. Long-term results have benefitted the recipient, employers and communities by increasing productivity and reducing the economic burden of disability, thus fulfilling our mission. A successful outcome measurement for the SHF requires a more personal aspect based on an individual´s improved quality of life including physical abilities, behavior, and outlook.

Methods: Eligible recipients choose their medical provider and modality of spine care. The SHF advocates on behalf of the recipient and provides the resources, as needed.

Results: To date, 14 recipients have received spine surgery through the Spine Health Foundation, Inc. Procedures have included; Anterior Lumbar Interbody Fusion for Degenerative Disc Disease and Disc Herniation, Cervical Laminectomy for Spinal Stenosis, Multi-level Lumbar Discectomy for Spondylotic Stenosis, Lumbar Disc Arthroplasty for Disc herniation and Derangement, Lumbar Epidural for Sciatica and Disc Herniation, and Hemilaminectomy for Lumbar Radiculopathy. Follow up data collection for 11 of 14 recipients was possible. In patients who received surgical treatment, the pre-op and post-op means and standard deviations were 9.6 ± 0.8 and 2.1 ± 1.3 with a p-value of less than 0.00000 (p˂ 0.00000). Summarized this small series demonstrated a significant, average delta 7.5 VAS improvement.

Conclusion: We desire to provide a national platform to eligible individuals who are either uninsured or under-insured in need of specialized spinal care. The SHF utilizes a new and innovative approach to fulfill our mission. To date, Spine Societies have yet to deliver a philanthropic platform for discussion that would allow for the much needed growth of the foundation. We humbly request formal avenues or societal links for future development.

Resources: www.spinehealthfoundation.org; http://www.youtube.com/watch?v=Xp3u-BX1LBw