New Study Examines Cost Differences of MIS vs Open Surgery from a Payer Perspective


Tue Mar 29 13:00:00 CDT 2016
Michael Morseon
Senior Director, Healthcare Economics, Policy and Reimbursement, Medtronic

Payers often grapple with the nuances of meeting economic goals without sacrificing patient outcomes. Patient health and safety is the top consideration of any healthcare system, but no one has unlimited financial resources. Fortunately, small changes in surgical approach can save money and improve clinical outcomes.


A pioneering study conducted by Milliman, Inc., and published in Managed Care magazine analyzed the differences in payer costs between minimally invasive surgery (MIS) and open surgery in a commercial population — so far, most studies have compared total hospital costs or operative costs. The study concluded that MIS procedures cost less for four common surgeries: colectomy, hysterectomy, ventral hernia repair and thoracic resection of the lung.


The review of more than 46,000 cases revealed cost savings in the thousands of dollars for several of the procedures. The authors demonstrated further cost savings over the 30-day post-operative period. This study suggests you can reach economic goals and outcomes by facilitating a mindset shift away from open surgeries to MIS, when an open procedure is not medically necessary (such as in the event of invasive tumors).


MIS linked to better clinical outcomes


A considerable volume of literature correlates the MIS approach to improved clinical outcomes. Specifically, MIS generally corresponds with shorter inpatient stays —especially in intensive care— lower rates of surgical site infections and re-hospitalizations, diminished surgical site pain, and a quicker return to work. Healthcare organizations can promote all of these patient benefits when they advocate for MIS approaches.


Real numbers, real savings


Let’s talk real numbers. The Milliman study offered these possible cost savings associated with MIS for common procedures:


  • Colectomy: MIS may save nearly $12,000 more than open surgery
  • Hysterectomy (non-cancerous): MIS saves more than $700 per patient versus open surgery
  • Ventral hernia repair: MIS saves more than $5,000 as compared to open surgery
  • Thoracic resection: MIS saves more than $12,000 when using MIS


These cost savings include “professional, facility and costs incurred 30 days after surgery,” according to the study’s authors. The study validates the fact that cost savings do not have to come at the expense of excellent clinical outcomes.

What are your experiences with minimally invasive techniques vs. open surgery? Has your organization evaluated the clinical and financial opportunities? Tell us in the comments field below.


Michael Morseon is currently Senior Director, Healthcare Economics, Policy and Reimbursement for Medtronic.