This document presents the Macon Value Formula, a quantitative method for comparing the value of spine interventions based on outcomes and costs. The formula calculates a relative value score from 0-1000 based on the number of patients, individual outcomes from 0-100, outcome success vs failure, total provider payments, and additional costs. The goal is to maximize value by identifying the most effective procedures while considering costs. The formula is summarized in a table and can help optimize the sequence of procedures to deliver high value and success for patients.

1. The Macon Value
Formula
James B. Macon, M.D.
Framingham NeuroSpine
Framingham, Massachusetts

3. Value Definition
Value for patients =
Health Outcomes per
$ Cost Expended
Porter, M.E. “A Strategy for Health Care
Reform – Toward a Value-Based System”
NEJM 361: 109-112, 2009

4. Value = Successful Outcomes
Provider Payments

5. Macon Value Formula
A Quantitative Value Analysis Formula
for Comparison of Spine Interventions
Based on Outcome and Cost Data

6. Formula Variables
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n is the number in the intervention group
Ok is the outcome for individual k (0-100)
s is 1 if outcome success and 0 if failure
Dk is the total provider payment (min. $100)
c is 1 for additional cost and 0 if no cost
V is the relative value calculated (0-1000)

7. Formula Steps
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Identify condition to be treated based on ICD9 codes
Identify intervention groups based on CPT code
Define group size n and number of groups in study
Define severity range of condition ( risk adjustment )
Define outcome measure for the data set (0-100 scale)
Define success range for outcome data (70-100)
Collect outcome data at the end of study time interval
Collect cost data = total payments to all providers
Enter outcome and cost data into spread sheet
Prepare formula summary table based on results
Use table results to optimize value and success
Plot value as a function of time to identify trends

11. Value Formula Summary Table
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CPT
VALUE
SUCCESS
COST
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62311
64
70%
$9,045
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63030
8
90%
$103,750
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62311/63030
21
100%
$38,645

12. Value-Based Conclusions
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The goal of care is to maximize group value
Maximum value is not maximum effectiveness
Maximum value is not always evidence-based
Less effective procedures may have high value
Sequence procedures to maximize group value
Order procedures to perform high value first
Perform high success low value procedures last
Eliminate ineffective unsuccessful procedures

13. To use the Macon Value Formula
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Request a copy of the spread sheet for use in
your practice to compare intervention groups
E-mail : macon@fnspine.com and request
The Macon value formula is copyright protected
by the U.S. Copyright Office
Credit the formula to the author when data is
presented or published.

14. E-mail : macon@fnspine.com
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ICD 9 of study
CPT for all groups
Group size and number
Outcome measurements
Success range definition
Severity range of condition
Crossover design
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