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Published on: October 17, 2025
Cost Savings Realized Through a Statewide Quality Improvement Collaborative for Spine Surgery
Background:
Quality improvement (QI) collaboratives represent a potentially powerful approach to QI, patient experience, and cost savings. In this article the authors present an estimate of direct cost savings to payers from reductions in the rate of a single adverse event (urinary retention) in the context of the Michigan Spine Surgery Improvement Collaborative (MSSIC).
Methods:
Data from the MSSIC clinical registry were used to calculate reductions in rates of urinary retention (with or without readmission) from a 2016 baseline period to a 2017-2024 QI intervention period. The number of those events averted, combined with dollar cost estimates of payments for treatment of adverse events from the Michigan Value Collaborative (MVC) was used to estimate direct cost savings to payers.
Results:
Direct cost savings to payers for the 2017-2024 period were estimated at $66.8 million.
Conclusion:
Given the combination of direct cost savings of $66.8 million and potential indirect cost savings to employers and caregivers of $130-$180 million, collaborative QI initiatives aimed at reducing rates of adverse outcomes after spine surgery can produce significant cost savings for payers, employers, and patients.
Insights
Quality improvement collaboratives significantly reduced urinary retention after spine surgery. This initiative saved payers $66.8 million, demonstrating the financial benefits of collaborative quality improvement in healthcare.
Area of Science:
- Healthcare Management
- Surgical Quality Improvement
- Health Economics
Background:
- Quality improvement (QI) collaboratives offer a promising strategy for enhancing patient care and reducing healthcare costs.
- The Michigan Spine Surgery Improvement Collaborative (MSSIC) focused on reducing adverse events, specifically urinary retention.
Purpose of the Study:
- To estimate the direct cost savings for payers resulting from a reduction in urinary retention following spine surgery.
- To evaluate the financial impact of the Michigan Spine Surgery Improvement Collaborative (MSSIC) initiative.
Main Methods:
- Utilized data from the MSSIC clinical registry to compare urinary retention rates between a 2016 baseline and a 2017-2024 QI intervention period.
- Calculated averted adverse events and applied cost estimates from the Michigan Value Collaborative (MVC) to determine direct payer savings.
Main Results:
- Estimated direct cost savings to payers amounted to $66.8 million for the 2017-2024 period.
- The reduction in urinary retention rates was the primary driver of these savings.
Conclusions:
- Collaborative QI initiatives targeting adverse outcomes in spine surgery yield substantial cost savings for payers.
- Potential indirect cost savings to employers and caregivers range from $130-$180 million, highlighting the broad economic benefits.
