Lown Institute Study Finds Unnecessary Back Surgeries Cost Medicare $600 Million Annually

A new analysis from the Lown Institute, an independent think tank, found that hospitals performed more than 200,000 unnecessary back surgeries on Medicare beneficiaries in the U.S. over three years. Roughly $2 billion was spent on the “low value” procedures while patients were put at risk of poor outcomes, researchers wrote.

The researchers looked at claims for common back surgeries, including spinal fusion, laminectomy, and vertebroplasty, over a three-year period for Medicare fee-for-service (2020-2022) and MA (2019-2021). Roughly 14% of spinal fusions and laminectomies met criteria for overuse, meaning patients with low back pain did not have certain diagnoses, such as trauma, a herniated disc, or scoliosis, and 11% of patient visits for osteoporotic fracture resulted in an unnecessary vertebroplasty.

Overuse rates varied greatly – from less than 1% to more than 50% – between hospitals, with New Hampshire, Iowa, Massachusetts, and Pennsylvania having the highest overuse rates of spinal fusion/laminectomy. Vikas Saini, president of the Lown Institute, said the variability is frustrating in its persistence, with data showing that the vast majority of vertebroplasties don’t work but it seems many doctors “still haven’t gotten the memo.”