Procedure-specific costs and savings in a mandatory program for second opinion on surgery

Area of Science:

• Health Economics
• Medical Decision Making

Background:

• Employer-sponsored second opinion programs aim to reduce medical costs.
• Previous analyses showed minimal overall cost savings.

Purpose of the Study:

• To analyze the cost-saving potential of a second opinion program for specific surgical procedures.
• To evaluate the impact of nonconfirming second opinions on patient decisions.

Main Methods:

• Analysis of surgery claims data from a large employer-sponsored second opinion program.
• Categorization of savings by procedure type, focusing on high-cost interventions.

Main Results:

• Overall medical resource cost savings were minimal.
• Significant savings were identified for high-cost procedures like hysterectomy, prostatectomy, back surgery, and hip replacement.
• Nonconfirming second opinions did not deter patients from proceeding with certain surgeries.

Conclusions:

• Second opinion programs can yield substantial savings for high-cost surgeries.
• Program design should consider procedure volume, cost, and the impact of nonconfirming opinions.
• Mandatory second opinions may benefit skeptical patients or those recommended controversial procedures.