Is Migraine Surgery Financially Viable for the Hospital and Surgeon? A Single-Surgeon, 10-Year Study at an Academic Institution.

[BACKGROUND] Data exist to demonstrate that migraine surgery is cost-effective for the long-term treatment of headaches, but no data exist regarding its financial viability for health care institutions. The goals of the current study were to demonstrate that migraine surgery is financially viable for an academic institution with a net-positive profitability and is a sought-after therapy that can draw patients into the health care system.

[METHODS] A retrospective chart review of migraine and bilateral breast reduction consults seen in clinic between May 1, 2011, and May 30, 2020, was conducted. Patient age, sex, payor information, and distance from the hospital were collected. Profit margin, percentage profit, collection percentage, and conversion rate to surgery from clinic were calculated.

[RESULTS] A total of 407 new migraine consults and 119 new breast reduction consults were included, of which 150 led to migraine operations and 117 to breast reduction, respectively. The migraine surgery group came from a farther distance for the initial consult ( P < 0.001) and for surgery ( P < 0.001). There were also more patients receiving migraine surgery from out of state ( P = 0.012). Migraine clinic patients had a larger ratio of private insurers ( P < 0.001). Patients receiving migraine surgery had a greater total charge ( P < 0.001), estimated reimbursement ( P = 0.001), and total cost ( P < 0.001).

[CONCLUSIONS] This study provides evidence that migraine surgery is financially viable for hospitals and, while migraine surgery performed similarly to breast reduction in profit margin, brought in more patients from outside the catchment area of the authors' institution. These findings may encourage hospitals to recruit migraine surgeons to improve care for this underserved patient population.