Table 1 Actual, price-standardized, and fully adjusted TRICARE payments during 60-, 90- and 180-day episode lengths for cervical and non-cervical spinal fusion
From: Strategies for spinal surgery reimbursement: bundling in the working-age population
DRG | Length of Bundle | Method of Cost Calculation | Quintile | Difference* (% of 1st Quintile) | ||||
|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | ||||
Cervical | 60 day bundle | Actual | $16,012 | $17,760 | $19,118 | $21,512 | $29,136 | $13,124 (82%) |
Price-Standardized | $16,671 | $18,084 | $19,203 | $21,341 | $27,562 | $10,891 (65%) | ||
Price Standardized + Casemix Adjusted | $16,728 | $18,059 | $19,112 | $21,236 | $27,281 | $10,553 (63%) | ||
90 day bundle | Actual | $16,677 | $18,472 | $19,929 | $22,420 | $30,259 | $13,581 (81%) | |
Price-Standardized | $17,389 | $18,865 | $20,061 | $22,166 | $28,532 | $11,143 (64%) | ||
Price Standardized + Casemix Adjusted | $17,459 | $18,804 | $19,960 | $22,077 | $27,997 | $10,538 (60%) | ||
180 day bundle | Actual | $18,575 | $20,560 | $22,426 | $24,884 | $33,528 | $14,953 (81%) | |
Price-Standardized | $19,483 | $20,949 | $22,616 | $24,550 | $31,129 | $11,646 (60%) | ||
Price Standardized + Casemix Adjusted | $19,570 | $20,880 | $22,309 | $24,377 | $30,261 | $10,691 (55%) | ||
Non-cervical | 60 day bundle | Actual | $25,879 | $29,324 | $32,028 | $35,551 | $49,211 | $23,331 (90%) |
Price-Standardized | $27,130 | $29,915 | $32,337 | $35,341 | $46,942 | $19,812 (73%) | ||
Price Standardized + Casemix Adjusted | $26,617 | $29,722 | $32,083 | $34,927 | $46,784 | $20,168 (76%) | ||
90 day bundle | Actual | $26,566 | $30,128 | $32,952 | $36,573 | $50,734 | $24,167 (91%) | |
Price-Standardized | $27,955 | $30,750 | $33,237 | $36,139 | $47,640 | $19,685 (70%) | ||
Price Standardized + Casemix Adjusted | $27,410 | $30,661 | $33,063 | $35,894 | $47,565 | $20,156 (74%) | ||
180 day bundle | Actual | $28,737 | $32,614 | $35,553 | $39,436 | $54,443 | $25,705 (89%) | |
Price-Standardized | $30,216 | $33,420 | $35,870 | $38,995 | $50,706 | $20,490 (68%) | ||
Price Standardized + Casemix Adjusted | $29,625 | $33,143 | $35,622 | $38,317 | $50,045 | $20,420 (69%) | ||