Amelio Cost Model Calculator
Assumptions
The assessment is against a population of individuals with persistent pain conditions.Treatment pathways include spinal cord stimulation, lumbar fusion, opioid prescriptions, and mental health medications.The model uses cost offsets from current research on the impact of psychosocial programs for self-managed pain management (see references below).Industry statistics from workers' compensation clients and relevant research papers (see references below).The model requires an understanding of case management/administration costs on a per-client basis. All other assumptions are based on industry standards.
Disclaimer
This model serves as an assessment tool, enabling companies to project potential outcomes and benefits derived from the Amelio Health program through the avoidance of health-care interventions, pharmaceutical prescriptions and reducing claim periods. It is designed to provide a framework to facilitate informed decision-making by simulating various scenarios based on current population information and healthcare trends.
Considerations for the Models use:
The model provides a macro-level perspective and should be used as a complement to business planning and business case development.
Companies are advised to interpret the results within the framework of their policy offerings, demographic profiles, and claims history to gauge the applicability and impact on their operations.
References
Cost $81,300 for lumbar spinal fusion and 23% requiring revision surgery by 24 months. And RTW rate 20% at 2-3 years (Anderson et al., 2018; Lewin et al., 2021)There was an increase in the proportion of workers using mental health treatment, from 243 of the 874 workers (27.8%) pre-surgery to 330 (37.8%) at 24 months postoperatively of those who had no mental health treatment before surgery (631, 72.2%), 165 (26.1%) were receiving treatment at 24 months (McMillan et al., 2021)In 2018/19 4794 stimulators were implanted and 2120 removed 44% 140 adverse events reported to TGA. Device malfunction and pain as the highest events reported (Jones et al., 2022).Spinal cord stimulator $58,000 41% need surgical review. Dr Rachel David CEO Private Healthcare Australia (ABC 4 Corners)There is a correlation between financial reward for doing procedures and the frequency at which those procedures are done Quote Prof Ian Harris 4 Corners Program (Butt & Harris, 2022) Anderson, J. T., Tye, E. Y., Haas, A. R., Percy, R., Woods, S. T., Ahn, U. M., & Ahn, N. U. (2018).Multilevel Lumbar Fusion Is a Risk Factor for Lower Return to Work Rates Among Workers’ Compensation Subjects With Degenerative Disc Disease. Journal of Surgical Orthopaedic Advances, 27(3), 209–218. Butt, K., & Harris, I. (2022).Making sense of sensibility: part 1. British Dental Journal, 232(5), 307–310. Jones, C. M. P., Shaheed, C. A., Ferreira, G., Mannix, L., Harris, I. A., Buchbinder, R., & Maher, C. G. (2022).Spinal Cord Stimulators: An Analysis of the Adverse Events Reported to the Australian Therapeutic Goods Administration. Journal of Patient Safety. https://doi.org/10.1097/PTS.0000000000000971 Lewin, A. M., Fearnside, M., Kuru, R., Jonker, B. P., Naylor, J. M., Sheridan, M., & Harris, I. A. (2021).Rates, costs, return to work and reoperation following spinal surgery in a workers’ compensation cohort in New South Wales, 2010-2018: a cohort study using administrative data. BMC Health Services Research, 21(1), 955. McMillan, J. S., Jones, K., Forgan, L., Busija, L., Carey, R. P. L., de Silva, A. M., & Phillips, M. G. (2021).Lumbar spinal fusion surgery outcomes in a cohort of injured workers in the Victorian workers’ compensation system. In ANZ Journal of Surgery. https://doi.org/10.1111/ans.17391