Is Migraine Surgery Financially Viable for the Hospital and Surgeon? A Single-Surgeon, Ten-Year Study at an Academic Institution.

Background: Data exists to demonstrate that migraine surgery is cost-effective for the long-term treatment of headaches, but no data exists regarding its financial viability for healthcare institutions. The goals of the current study are to demonstrate that (1) migraine surgery is financially viable for an academic institution with a net-positive profitability and (2) migraine surgery is a sought-after therapy that can draw patients into the healthcare system.

Methods: A retrospective chart review of migraine and bilateral breast reduction (BBR) consults seen in clinic between 05/01/2011-05/30/2020 was conducted. Patient age, sex, payor information, and distance from the hospital was collected. Profit margin, percentage profit, collection percentage, and conversion rate to surgery from clinic was calculated.

Results: 407 new migraine consults and 119 new BBR consults were included from which, 150 underwent migraine surgeries and 117 underwent BBR respectively. Migraine surgery group came from a further distance for the initial consult (P-value<0.001) and for surgery (P-value<0.001). There were also more migraine surgery patients from out-of-state (P-value=0.012). Migraine clinic patients had a larger ratio of private insurers (P-value<0.001). Migraine surgery patients had a greater total charge (P-value<0.001), estimated reimbursement (P-value=0.001), and total cost (P-value<0.001).

Conclusions: This study provides evidence that migraine surgery is financially viable for hospitals and while performing similarly to bilateral breast reduction in profit margin, it brought in more patients from outside the catchment area of our institution. These findings may encourage hospitals to recruit migraine surgeons to improve care for this underserved patient population.