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Increasing Utilization of Advanced Practice Providers in Spine Surgery from 2013 to 2022: A Medicare Part B Analysis
Mark Miller1, Matthew Meade, Maneesha Palakurthi
1From the (Dr. Miller, Dr. Meade, Dr. Nanavati, Dr. Gupta, Dr. DiCiurcio), Stratford, NJ; Rothman Orthopaedic Institute (Palakurthi, Sherman, Dr. Kepler, Dr. Schroeder, Dr. Woods), Philadelphia, PA; Georgetown University School of Medicine (Sbaih), Washington, DC.
Advanced practice providers (APPs) are increasingly involved in spine care, with their numbers rising significantly. This trend is projected to continue, especially in rural areas, due to the growing need for spinal disorder treatment.
Area of Science:
- Orthopedics
- Healthcare Policy
- Health Services Research
Background:
- The demand for healthcare services has increased, leading to a greater role for advanced practice providers (APPs), including nurse practitioners (NPs) and physician assistants (PAs).
- Understanding the trends in APP utilization for spinal disorders is crucial for healthcare planning.
Purpose of the Study:
- To evaluate trends in the prevalence, reimbursement, and characteristics of care provided by APPs in the United States for spinal disorders between 2013 and 2022.
Main Methods:
- A retrospective cohort study utilized the Medicare Provider Utilization and Payment database (2013-2022).
- Provider-type and billing codes identified APPs and spine surgeons providing diagnostic, procedural, and therapeutic services for spine patients.
- Linear regression modeling was used for trend analysis and projections to 2030.
Main Results:
- The number of spine surgeons decreased slightly, while the number of APPs providing spine care increased by 23.3% (1600 in 2013 to 1974 in 2022).
- APPs most commonly billed for radiographs and office visits.
- APPs were more likely to be spine providers in rural areas (OR: 1.20). Projections indicate these trends will continue through 2030.
Conclusions:
- The utilization of APPs in managing spinal pathology is increasing and is expected to rise further.
- This trend aligns with the growing prevalence of spinal disorders and the increasing demand for healthcare services.
