Abstract
The pressures on spine surgery to adopt value-based reimbursement models are being seen in the increased implementation of bundled payment strategies. Given that bundled payment models typically link payments to the initiation of the surgical episode in question, despite their potential cost-saving attributes, financial incentives remain tied to the volume of services being provided. As payors and policy makers look to find savings by focusing on waste and variation of care, more comprehensive models such population health strategies are now being develop and deployed. The clinical delivery and cost variation currently seen in spine health management make spine surgery an acute target of such population health strategies. Spine surgeons should understand the forces driving such changes and the opportunities to optimize performance within them.
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