(01/28/13) - A special carpet could ensure a common surgery stays covered by
insurance. ACL injuries have increased 400 percent in teens and adolescents in
the last 10 years. They're also on the rise among baby boomers.
A few months ago, Chris Spinelli tore his ACL playing soccer. "I planted and he ran into me and hit my knee at just a funny angle and I just went right down."
Dr. Mike Maloney says surgery gets patients back to near-normal, but healthcare reform may change whether it's covered by insurance. Doctors will soon need to prove the knee surgery helps.
"There's a huge challenge that a lot of the procedures we do have not gone through that rigor and therefore, third party payers may say, 'we're not going to pay for them anymore,'" Maloney says.
That is where the Gait-Rite system comes in. The 26-foot carpet contains sensors to assess gait after injury, and again after surgery to show how patients are doing.
"We will have seen that their gait has been restored to what we consider normal and safe and allow them to progress," Maloney says.
The Gait-Rite also identifies those who are not recovering well. It is good for patients, but the system is really a way to curb potential problems with insurance coverage when new healthcare laws go into effect.
Chris says he doesn't know what he would have done if his insurance had not covered the procedure. "There's just no way I would have been able to do the surgery and then I'd be like, 'what am I gonna do'?"
Of the roughly 200,000 ACL injuries a year, nearly half are fixed with surgery. Surgery cost ranges from $20,000 to $50,000, followed by months of rehab.
For more information on Dr. Maloney's work, visit http://www.nejmcareercenter.org/article/92/physician-compensation-models-big-changes-ahead/
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