The Rapid Response Team of the Joint Spine Section stays busy responding to payer policy changes and to an array of challenges to providing spine care. A recent potential limitation to patient access to surgical treatment of cervical disc herniations failing conservative therapy was proposed by the Health Care Authority in Washington State. The response of organized spine surgery, spear- headed by the efforts of the Joint Section’s Rapid Response Team, were presented at last year’s CNS meeting and published recently here.

Organized neurosurgery has learned that local policy can quickly become national policy. Answering challenges to patient access at a local level may prevent wider policies that impact our patients and limit their options in seeking surgical care.

The Bree Collaborative, also in Washington State, has recently proposed a bundled approach to lumbar fusion surgeries and a warranty for lumbar spine procedures. The Rapid Response Team formulated a response to a set of questions proposed by the Bree group. Since these proposals have the potential to impact spine surgeons nationwide, we will succinctly review aspects of the proposal here.

The entirety of the Bree proposals are hosted at their website, the lumbar fusion bundle and the lumbar warranty are on separate pages. We will hit some of the high points from the 2 documents here; interested readers can reference the source material for further information.