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Medicare pays billions for questionable back surgeries for older adults

A new analysis revealed that Medicare spent roughly $2 billion over three years on unnecessary back surgeries for older adults. This alarming figure comes from research conducted by the nonpartisan Lown Institute think tank. The study examined common procedures including spinal fusion, laminectomy, and vertebroplasty, finding that an unnecessary back surgery is performed on a Medicare beneficiary every eight minutes. More than 200,000 procedures were identified as potentially unnecessary during the study period. More

Unnecessary back surgeries cost Medicare billions

Over 200,000 back surgeries were performed unnecessarily in the United States over the course of three years, according to a new Lown Institute report. In sum, these low-value back procedures cost Medicare about $2 billion after three years, roughly $600 million annually. “We trust that our doctors make decisions based on the best available evidence, but that’s not always the case,” Vikas Saini, MD, president of the Lown Institute, said in an organizational release. “In spinal surgery, as with other fields of medicine, physicians routinely overlook evidence to make exceptions, sometimes at shockingly high rates. This type of waste in Medicare is costly, both in terms of spending, and in risk to patients.” More

Black mothers more likely to get unnecessary C-sections, study says

Are Black mothers more likely to have unscheduled C-sections? A new working paper from the National Bureau of Economic Research suggests yes–and that their likelihood of an unscheduled C-section was greater when there were operating rooms going unused.  Same hospital, different c-section rates While C-sections can be a lifesaving option when necessary, they are invasive […] More

Can AI help reduce medical debt? It depends on how hospitals use it…

Could AI and other machine learning help ameliorate our nation’s medical debt crisis—or will it make the problem worse? It all depends on how hospitals use these tools, write Kelsey Chalmers, PhD, our own Director of Research, Data Science at the Lown Institute, and Christopher W. Goodman, MD, Clinical Assistant Professor of Internal Medicine at the University of South Carolina School of Medicine, in a recent JAMA Internal Medicine viewpoint. More

Harris and Walz fought health-care corporate power — to a point

While Harris and Walz have challenged corporate power, politicians do so only because voters are pushing for it, cautioned Vikas Saini, president of the Lown Institute, a health-care think tank.

“The health-care corporations now are mega-regional players. They have huge clout. It would really take much more than a single politician,” Saini said. “It’s going to take a broader movement in the country. … Maybe we’ll get there as there is a lot of pain.”

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Should patients care about 340B? 

340B is more than a big pile of money. The program is a band-aid covering up huge problems with our health system that can no longer be ignored. The 340B drug discount program is a hugely important policy issue for hospitals and drug companies, but the most of the rest of us have never heard of it or barely understand it. Why is pharma and the hospital industry getting so worked up about 340B, and how does any of this matter? Here’s what you need to know about a growing policy battle… More