Health Literacy and Early Physical Activity After Solid Organ Transplantation: A Prospective Observational Study.

Managing excessive healthcare costs is an increasingly urgent problem in the United States (US), where Americans spent $4.5 trillion on healthcare in 2022 alone []. These large expenditures are not, however, made efficiently, with some estimates placing nearly 25% of all healthcare spending in the form of low-value care, poor care coordination, and administrative bloat []. One strategy in combating inefficiencies is the development of centers of excellence (COE). These interdisciplinary programs seek to identify and encourage centers that maximize provision of high-value care, control costs, and improve patient outcomes, and spinal care has been the focus of many of these efforts, with some early research indicating that they may reduce costs while preserving or improving the quality of care [, ]. However, facilities that call themselves “spine centers” are not subjected to the same regulatory standards as other forms of COE [–]. Several independent organizations certify spine centers, but there is no specific accreditation required for a facility to identify itself as a “spine center” []. This has led to a lack of standards for what constitutes a spine center. Existing spine centers can vary in size, characteristics, and scope of practice, ranging from large multidisciplinary care centers affiliated with academic institutions to single doctors working with external practitioners. The resulting heterogeneity of practice sites presented to the public as “spine centers” is thus confusing to patients seeking reliable spinal care, insurance providers seeking to standardize payments for spine center services, and practitioners seeking employment in spine-related care. This study aims to analyze the characteristics of spine centers in the Northeastern United States, stratified by formal accreditation status, to identify key similarities among existing centers and to develop a profile to identify and designate future centers.