{"id":"https://openalex.org/W2233617246","doi":"https://doi.org/10.1097/brs.0000000000001212","title":"A Survey of Innovative Reimbursement Models in Spine Care","display_name":"A Survey of Innovative Reimbursement Models in Spine Care","publication_year":2015,"publication_date":"2015-11-14","ids":{"openalex":"https://openalex.org/W2233617246","doi":"https://doi.org/10.1097/brs.0000000000001212","mag":"2233617246","pmid":"https://pubmed.ncbi.nlm.nih.gov/26555826"},"language":"en","primary_location":{"id":"doi:10.1097/brs.0000000000001212","doi":"https://doi.org/10.1097/brs.0000000000001212","is_oa":false,"landing_page_url":"https://doi.org/10.1097/brs.0000000000001212","pdf_url":null,"source":{"id":"https://openalex.org/S4026894","display_name":"Spine","issn_l":"0362-2436","issn":["0362-2436","1528-1159"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-b","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SPINE","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"http://nrs.harvard.edu/urn-3:HUL.InstRepos:41973499","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5110343758","display_name":"Alex Kazberouk","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Alex Kazberouk","raw_affiliation_strings":["*Harvard Medical School, Boston, Massachusetts\u2020Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts\u2021Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts","No funds were received in support of this work","Relevant financial activities outside the submitted work: consultancy, patents, payment for lectures","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.spinejournal.com)","The manuscript submitted does not contain information about medical device(s)/drug(s)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"*Harvard Medical School, Boston, Massachusetts\u2020Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts\u2021Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I136199984"]},{"raw_affiliation_string":"No funds were received in support of this work","institution_ids":[]},{"raw_affiliation_string":"Relevant financial activities outside the submitted work: consultancy, patents, payment for lectures","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.spinejournal.com)","institution_ids":[]},{"raw_affiliation_string":"The manuscript submitted does not contain information about medical device(s)/drug(s)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5006563842","display_name":"Kevin J. McGuire","orcid":"https://orcid.org/0000-0003-1069-4790","observed_orcids":["https://orcid.org/0000-0003-1069-4790"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Kevin McGuire","raw_affiliation_strings":["No funds were received in support of this work","Relevant financial activities outside the submitted work: consultancy, patents, payment for lectures","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.spinejournal.com)","The manuscript submitted does not contain information about medical device(s)/drug(s)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"No funds were received in support of this work","institution_ids":[]},{"raw_affiliation_string":"Relevant financial activities outside the submitted work: consultancy, patents, payment for lectures","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.spinejournal.com)","institution_ids":[]},{"raw_affiliation_string":"The manuscript submitted does not contain information about medical device(s)/drug(s)","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5072276755","display_name":"Bruce E. Landon","orcid":"https://orcid.org/0000-0003-4912-0647","observed_orcids":["https://orcid.org/0000-0003-4912-0647"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Bruce E. Landon","raw_affiliation_strings":["E-mail: [email\u00a0protected]","No funds were received in support of this work","Relevant financial activities outside the submitted work: consultancy, patents, payment for lectures","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.spinejournal.com)","The manuscript submitted does not contain information about medical device(s)/drug(s)","reprint requests to Bruce E. Landon, MD, MBA, MSc, Harvard Medical School, Department of Health Care Policy, 180 Longwood Avenue, Boston, MA 02115-5899"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"E-mail: [email\u00a0protected]","institution_ids":[]},{"raw_affiliation_string":"No funds were received in support of this work","institution_ids":[]},{"raw_affiliation_string":"Relevant financial activities outside the submitted work: consultancy, patents, payment for lectures","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.spinejournal.com)","institution_ids":[]},{"raw_affiliation_string":"The manuscript submitted does not contain information about medical device(s)/drug(s)","institution_ids":[]},{"raw_affiliation_string":"reprint requests to Bruce E. Landon, MD, MBA, MSc, Harvard Medical School, Department of Health Care Policy, 180 Longwood Avenue, Boston, MA 02115-5899","institution_ids":["https://openalex.org/I136199984"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5072276755"],"corresponding_institution_ids":["https://openalex.org/I136199984"],"apc_list":null,"apc_paid":null,"fwci":14.4775,"has_fulltext":false,"cited_by_count":52,"citation_normalized_percentile":{"value":0.98643181,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"41","issue":"4","first_page":"344","last_page":"352"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9771000146865845,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9771000146865845,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.006599999964237213,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10238","display_name":"Spine and Intervertebral Disc Pathology","score":0.004699999932199717,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/bundled-payment","display_name":"bundled payment","score":0.984000027179718},{"id":"https://openalex.org/keywords/fee-for-service","display_name":"fee-for-service","score":0.9409999847412109},{"id":"https://openalex.org/keywords/spine-surgery","display_name":"spinal surgery","score":0.6830000281333923},{"id":"https://openalex.org/keywords/low-back-pain","display_name":"low back pain","score":0.9490000009536743},{"id":"https://openalex.org/keywords/cost-effectiveness","display_name":"cost-effectiveness","score":0.628000020980835},{"id":"https://openalex.org/keywords/employer-sponsored-health-insurance","display_name":"employer-sponsored health insurance","score":0.492000013589859}],"concepts":[{"id":"https://openalex.org/C2779703844","wikidata":"https://www.wikidata.org/wiki/Q760125","display_name":"Reimbursement","level":3,"score":0.8786166310310364},{"id":"https://openalex.org/C145097563","wikidata":"https://www.wikidata.org/wiki/Q1148747","display_name":"Payment","level":2,"score":0.7112538814544678},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6937836408615112},{"id":"https://openalex.org/C195487862","wikidata":"https://www.wikidata.org/wiki/Q850210","display_name":"Revenue","level":2,"score":0.6167404055595398},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5620936155319214},{"id":"https://openalex.org/C2776204158","wikidata":"https://www.wikidata.org/wiki/Q7156607","display_name":"Pay for performance","level":3,"score":0.48496079444885254},{"id":"https://openalex.org/C2780378061","wikidata":"https://www.wikidata.org/wiki/Q25351891","display_name":"Service (business)","level":2,"score":0.4776260256767273},{"id":"https://openalex.org/C162118730","wikidata":"https://www.wikidata.org/wiki/Q1128453","display_name":"Actuarial science","level":1,"score":0.347055047750473},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.27716487646102905},{"id":"https://openalex.org/C162853370","wikidata":"https://www.wikidata.org/wiki/Q39809","display_name":"Marketing","level":1,"score":0.2606595456600189},{"id":"https://openalex.org/C10138342","wikidata":"https://www.wikidata.org/wiki/Q43015","display_name":"Finance","level":1,"score":0.19441065192222595},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.09453731775283813},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D001416","descriptor_name":"Back Pain","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013131","descriptor_name":"Spine","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D018588","descriptor_name":"Fee-for-Service Plans","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D018803","descriptor_name":"Models, Economic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D019547","descriptor_name":"Neck Pain","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":false},{"descriptor_ui":"D019637","descriptor_name":"Orthopedic Procedures","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1097/brs.0000000000001212","doi":"https://doi.org/10.1097/brs.0000000000001212","is_oa":false,"landing_page_url":"https://doi.org/10.1097/brs.0000000000001212","pdf_url":null,"source":{"id":"https://openalex.org/S4026894","display_name":"Spine","issn_l":"0362-2436","issn":["0362-2436","1528-1159"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-b","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SPINE","raw_type":"journal-article"},{"id":"pmid:26555826","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/26555826","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Spine","raw_type":"Journal Article"},{"id":"pmh:oai:dash.harvard.edu:1/41973499","doi":null,"is_oa":true,"landing_page_url":"http://nrs.harvard.edu/urn-3:HUL.InstRepos:41973499","pdf_url":null,"source":{"id":"https://openalex.org/S4306401540","display_name":"Digital Access to Scholarship at Harvard (DASH) (Harvard University)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I136199984","host_organization_name":"Harvard University","host_organization_lineage":["https://openalex.org/I136199984"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"","raw_type":"Thesis or Dissertation"}],"best_oa_location":{"id":"pmh:oai:dash.harvard.edu:1/41973499","doi":null,"is_oa":true,"landing_page_url":"http://nrs.harvard.edu/urn-3:HUL.InstRepos:41973499","pdf_url":null,"source":{"id":"https://openalex.org/S4306401540","display_name":"Digital Access to Scholarship at Harvard (DASH) (Harvard University)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I136199984","host_organization_name":"Harvard University","host_organization_lineage":["https://openalex.org/I136199984"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"","raw_type":"Thesis or Dissertation"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9391000270843506,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":19,"referenced_works":["https://openalex.org/W1963847570","https://openalex.org/W1979431113","https://openalex.org/W1993585602","https://openalex.org/W1995130676","https://openalex.org/W2004769345","https://openalex.org/W2026242899","https://openalex.org/W2027037950","https://openalex.org/W2027853925","https://openalex.org/W2030430403","https://openalex.org/W2038133684","https://openalex.org/W2067689995","https://openalex.org/W2078845079","https://openalex.org/W2110132004","https://openalex.org/W2139975414","https://openalex.org/W2150915739","https://openalex.org/W2156801967","https://openalex.org/W2167169531","https://openalex.org/W2317608712","https://openalex.org/W2335458513"],"related_works":["https://openalex.org/W3155875382","https://openalex.org/W2949387528","https://openalex.org/W2899365291","https://openalex.org/W2905101836","https://openalex.org/W7220857593","https://openalex.org/W2739239001","https://openalex.org/W639977940","https://openalex.org/W2601869935","https://openalex.org/W2280024758","https://openalex.org/W3084672368"],"abstract_inverted_index":{"STUDY":[0],"DESIGN:":[1],"Structured":[2],"key":[3],"informant":[4],"interviews":[5,129],"with":[6,91],"follow-up.":[7],"OBJECTIVE:":[8],"The":[9,37],"aim":[10],"of":[11,29,137,150,176,185,256],"the":[12,27,94,132,148,257],"study":[13],"was":[14],"to":[15,53,119,130,183,189,233,302],"describe":[16],"innovative":[17,79],"reimbursement":[18,64,171,287,299],"models":[19,65,81,237,254,288],"in":[20,82,93,102,263,297],"spine":[21,30,83,107,151,167,187,264,293,298],"care":[22,31,57,108],"and":[23,62,73,89,109,123,134,143,145,198,206,227,248,308],"gather":[24],"perspectives":[25,146],"on":[26,44,78,147,291],"future":[28,149],"reimbursement.":[32,152],"SUMMARY":[33],"OF":[34,311],"BACKGROUND":[35],"DATA:":[36],"United":[38],"States":[39],"spends":[40],"$90":[41],"billion":[42],"annually":[43],"medical":[45],"expenses":[46],"for":[47,71,106,173,214,238],"low":[48],"back":[49,240],"pain.":[50],"One":[51],"approach":[52],"promoting":[54],"high-quality,":[55],"cost-effective":[56,279],"is":[58],"through":[59],"bundled":[60,103,193,216,270],"payments":[61,194,271],"other":[63,303],"wherein":[66],"physicians":[67],"are":[68,220,230,261],"held":[69],"accountable":[70],"costs":[72],"utilization.":[74],"Little":[75],"data":[76],"exist":[77],"payment":[80,104,236],"care.":[84,265,280,294],"METHODS:":[85],"Through":[86],"literature":[87],"review":[88],"discussions":[90],"leaders":[92],"field,":[95],"we":[96],"identified":[97],"organizations":[98,117,160,180,283],"that":[99,161,267,289],"were":[100],"engaged":[101],"initiatives":[105,219],"surgery.":[110],"These":[111],"included":[112],"healthcare":[113],"systems,":[114],"physician":[115],"groups,":[116],"helping":[118],"set":[120],"up":[121],"bundles,":[122],"a":[124,174],"large":[125],"employer.":[126],"We":[127,154],"conducted":[128],"understand":[131],"background":[133],"specific":[135],"features":[136],"each":[138],"initiative,":[139],"generalizable":[140],"success":[141,225],"factors":[142,226],"challenges,":[144],"RESULTS:":[153],"interviewed":[155],"24":[156],"stakeholders":[157],"across":[158],"18":[159],"collectively":[162],"perform":[163],"approximately":[164],"12,000":[165],"inpatient":[166],"surgeries":[168],"annually.":[169],"Fee-for-service":[170],"accounts":[172],"majority":[175],"revenue,":[177],"but":[178,222],"several":[179],"expect":[181],"30%":[182],"45%":[184],"their":[186],"volume":[188],"be":[190],"covered":[191],"under":[192],"within":[195],"3":[196],"years":[197],"cite":[199],"new":[200],"patient":[201,246,274],"volume,":[202],"increased":[203],"surgical":[204],"yield,":[205],"financial":[207],"benefits":[208],"from":[209,276],"efficiency":[210],"improvements":[211],"as":[212],"reasons":[213],"adopting":[215],"payments.":[217],"Current":[218],"heterogeneous,":[221],"share":[223],"similar":[224],"challenges.":[228],"Institutions":[229],"more":[231],"hesitant":[232],"adopt":[234,269],"risk-based":[235],"chronic":[239],"care,":[241],"citing":[242],"difficulty":[243,249],"modeling":[244],"risk,":[245],"heterogeneity,":[247],"aligning":[250],"incentives.":[251],"CONCLUSION:":[252],"Payment":[253],"outside":[255],"traditional":[258],"fee-for-service":[259],"paradigm":[260],"emerging":[262],"Providers":[266],"preemptively":[268],"can":[272],"increase":[273],"volumes":[275],"payers":[277],"seeking":[278],"Going":[281],"forward,":[282],"should":[284],"begin":[285],"considering":[286],"focus":[290],"noninterventional":[292],"Finally,":[295],"developments":[296],"may":[300],"apply":[301],"procedure-based":[304],"specialties,":[305],"including":[306],"orthopedics":[307],"cardiology.":[309],"LEVEL":[310],"EVIDENCE:":[312],"5.":[313]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2024,"cited_by_count":2},{"year":2022,"cited_by_count":2},{"year":2021,"cited_by_count":6},{"year":2020,"cited_by_count":8},{"year":2019,"cited_by_count":11},{"year":2018,"cited_by_count":10},{"year":2017,"cited_by_count":9},{"year":2016,"cited_by_count":1}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2016-06-24T00:00:00"}
