From the One Big Beautiful Bill Act to CMS’ proposed rules in 2026, spine surgeons are keeping up with a constantly evolving landscape of federal policies and regulations that affect their work.
Along with staying on top of the news, spine surgeons are engaging with professional development and having a laser focus on patient outcomes.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker’s invites all spine surgeon and specialist responses.
Next question: How have recent advancements in endoscopic spine surgery changed the landscape of minimally invasive spine treatments?
Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CDT Tuesday, July 29.
Editor’s note: Responses were lightly edited for clarity.
Question: As federal regulations evolve rapidly—especially around quality measures and reimbursement—what strategies or resources are helping you stay ahead in your practice?
Tan Chen, MD. Geisinger Musculoskeletal Institute (Danville, Pa.): We live in an interesting time with a rapidly evolving regulatory environment, and I believe staying informed is crucial to maintaining a successful practice. I personally try to stay ahead of the curve by actively participating in continuing education and professional development, enrolling in quality improvement initiatives, engaging with professional associations, and implementing EMR-based data analytics to monitor quality metrics. These efforts allow me to ensure my practice remains compliant and able to deliver high quality spine care to my patients.
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: In our practice, we think consistency leads to better outcomes over ticking boxes. Staying ahead of the curve sometimes means stepping out of the curve’s way and focusing on doing the right surgery for the right patient. That alone can many times win the day. It is important to keep demonstrable results and good patient satisfaction over trying to please the pearls and clipboard committee.
Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): The difficulty is that people use the term “value” as a buzzword, passionate cry, and a weapon. The equation is simplified as outcomes over cost. But, we have yet to figure out what the most meaningful outcomes are and how to best capture them. Similarly, there are so many costs and perspectives that our system simply is not currently capturing.
At our center, we’re investing in understanding the true definition of “value” across all stakeholders; more so than just the cost side of the equation. But including the outcomes that matter most to patients, providers and systems. This includes launching research around patient-specific risk tolerance, understanding the responsible adoption and innovation of enabling technologies, and trying to figure out what the most meaningful outcomes to follow are.
There is a lot of pessimism right now. I am trying to keep a glass-half-full perspective. Trying to convince myself that regulations may define the floor, but it’s our collective insight and work that should define the ceiling; and we better start figuring that out soon.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Within a larger health system, the decades use of Crimson Criteria was recently transitioned to Midas STATIT, whereby Complications of Care, Length of Stay, 30 Day Readmissions Rates and quality indicators including Patient Experience are collectively benchmarked against other peers. Standards for all metrics are collected and reviewed quarterly and reviewed on a personal and departmental level. Having this quality service available and working for patients and providers is quite the advantage.
