Surgical Warranty

Medicine is a field without guarantees, but that may be about to change, at least in spinal surgery.

Dr. Ara Deukmedjian, aka Dr. Deuk, a neuro-spine surgeon with Deuk Spine Institute in Melbourne and Surgery Center of Viera, is now offering warranties for spine surgeries. Under the new warranty, Deukmedjian's practice assures its patients that their back pain will be eliminated after surgery. If not, any additional treatments will be provided at no cost.

The warranty covers the area of the spine where the surgery took place, be it the cervical or lumbar region. It does not cover both. All services must be provided at the Deuk Spine Institute and Surgery Center of Viera.

Deukmedjian instituted the new warranty program a couple of months ago after years of research. Working with Millennium Medical Management and other advisers to develop the warranty, Deukmedjian now guarantees that his practice will eliminate all back pain, chronic or not.

"It was born out of the fact that our surgical practice does extremely well," said Deukmedjian.

"We're able to offer the warranty because we have proven outcomes, thanks to our ability to offer all the services a patient needs in-network. We do diagnostic testing, therapy, medication, interventional pain management and surgery as part of the package. Because of this, we're willing to stand behind our results, to cover any additional treatment the patient may need."

"It's a win-win-win situation," said Deukmedjian.

Data on the office's rate of infections and complications fueled Deukmedjian's decision to institute the warranty.

Deukmedjian admits that he is able to offer the warranty because he performs these procedures at the Surgery Center in Viera and not at a hospital, even though he is on staff at Parrish and Wuesthoff Medical Centers and at Viera Hospital.

"Most surgeons do this type of surgery at a hospital, and surgeons, even if they have great outcomes, don't own the hospital," said Deukmedjian. "This warranty model would not work in a hospital setting."

The Deuk Spine Institute specializes in minimally invasive laser surgery. In addition to ambulatory surgery, the Deuk Spine Institute includes all the elements of comprehensive spine care under one roof, so it can control the cost of care.

"It lowers administrative costs," said Deukmedjian. "If there is no additional treatment needed, then there is no additional cost to us."

Initial interest in the new Deuk warranty has been brisk.

"The response has been fantastic from patients, insurance companies and work comp carriers," said John Stewart, vice president of business development at Deuk Spine Institute.

While the warranty can seem very tempting to patients and insurers, there is a caveat. An additional cost must be paid by the insurer or patient in order for the warranty to be in effect.

"The warranty differs in price depending on what type of procedure is performed," said Stewart.

The warranty is primarily aimed at workers' comp and to self-insured companies such as Harris Corporation or Embraer and self-paying patients.

"Risk is mitigated up front," said Deukmedjian.

"The company knows it doesn't have to spend any more money. We think it can be very attractive for workers' comp, since they own the injury for the rest of the patient's life."

For patients, there is also a considerable convenience factor. Once a patient under the warranty need additional care, he or she would not have to seek and wait for payer approval for diagnostic testing and treatment, since all costs are already covered. Per agreement, patients do not need to make co-pays after the initial payment.

From the standpoint of major insurance carriers, the warranty may not be as attractive. Providing long-term assurance that treatment will be administered at no cost down the road may not resonate with carriers that see significant turnover in enrollment numbers as employees leave for other jobs and other carriers.

Individual patients can opt to pay for the warranty even if their insurance company does not cover the costs.

"We have quite a few finance options for a patient to self-pay," said Stewart.

Warranty costs vary according to the age of the patient. Deuk Spine Institute assumes risk for care of the patient's spine in the same region where surgery was performed from day one to the end of the total number of years purchased. The warranty can be purchased in one-year increments up to the patient's lifetime.

So far, Deukmedjian has not had to make good on the warranty, since none of the patients has treated have developed any problems since their surgery. That is as he expected.

"The warranty is so new people are having a hard time fathoming how we can actually do this," said Stewart.

"In order to offer this you have to have very predictable surgical outcomes."

Maria Sonnenberg, For FLORIDA TODAY