PBGH Turns Focus To Spinal Surgeries

The Pacific Business Group on Health (PBGH), one of the state's biggest group purchasers, has expanded a value-based purchasing program to include spinal surgeries.  

The procedure – which has drawn controversy because of its costs and criticisms in some quarters because it is thought to be overutilized – is being added to PBGH's Employers Centers of Excellence Network.

Altogether, about 600,000 Americans – and about 80,000 Californians – undergo spinal surgeries every year, according to data from the American Association of Orthopedic Surgeons. However, a variety of studies have questioned the efficacy of the procedure, which can cost $100,000 or more to perform. The surgery has also been the nexus of fraud, with the former owner of Pacific Hospital in Long Beach pleading guilty last year to federal charges of paying bribes in order to receive worker's compensation referrals for spinal surgery cases. Former State Senator Ron Calderon is also facing charges of accepting bribes in order to craft legislation favorable to Pacific Hospital performing more spinal surgeries.

Under the PBGH program, three out-of-state hospitals will perform spinal surgeries for the participating employers, which include big-box retailers Wal-Mart's and Lowe's. The facilities are  Geisinger Medical Center in Danville, Penn., Mercy Hospital in Springfield, Mo., and the Virginia Mason Medical Center in Seattle.

“We vigorously evaluated the participating hospitals’ experience in evidence-based medicine and use of consistently applied patient appropriateness criteria to ensure that participating employees are receiving higher quality care,” said PBGH Chief Executive Officer David Lansky in a statement. A PBGH official did not respond to a phone call seeking comment.

The EECN program was launched last year to perform hip and knee replacements at a group of hospitals that provides positive patient outcomes at low costs. 

To date the program has performed 585 replacement surgeries.