Treatment Costs of Chiari Malformation Type 1

Healthcare resources are limited; cost containment is always the top priority for health policymakers. To balance between cost and quality of care is the ultimate goal. The CMS Bundled Payments for Care Improvement (BPCI) was initiated in 2010. The stated purpose is to drive toward a higher quality of care while containing costs. While this payment format has not yet affected pediatric care or neurosurgical care, it is important for surgeons, healthcare providers, hospital systems, and payers to understand costs and risks. In this chapter, our discussion will focus on healthcare costs from a payer’s perspective. Chiari malformation type I (CM I) is a common entity treated on a typically elective basis in pediatric neurosurgery, and surgical treatment of this disease presents a significant outlay of healthcare expenditures. As payers continue to develop reimbursement models for the bundling of payments, it is becoming increasingly important to define the costs of elective surgical procedures such as that for CM I. The chapter will use an illustrative study to describe how to identify the drivers of hospitalization costs and develop a hospitalization cost model for the surgical treatment of pediatric CM I.