Shrinking reimbursements, rising expectations for outcome data, and the slow march toward value-based payment are forcing spine surgeons to rethink their strategies for long-term sustainability.
Three surgeons discuss what will set the successful spine practices apart from the rest.
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: What’s a capability spine surgeons will need to stay independent over the next five years that wasn’t necessary a decade ago?
Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CDT Tuesday, March 24.
Editor’s note: Responses were lightly edited for clarity.
Question: Looking ahead five years, what will distinguish a thriving spine practice from one that struggles to survive?
Krishna Satyan, MD. Dallas Neurosurgical & Spine (Plano, Texas): There are many factors that will help a private practice thrive, but the main goal is to maintain a steady influx of new patient referrals. The best way to do that is to build a strong referral system by consistently maintaining relationships with existing patients and with referring physicians.
A practice’s patients are often its best advocates. If patients enjoy their experience, feel comfortable with the care they receive, and leave with their questions clearly answered, they are more likely to refer others and share positive reviews. In addition, satisfied patients often convey that appreciation to their referring physicians, which strengthens those relationships over time.
It is also important for a private practice to be financially sound. This requires strong management and thoughtful contracting with insurance companies. Over time, payers consistently try to reduce reimbursement, so practices need to be proactive. To navigate that pressure, having multiple physicians in a practice, delivering consistently strong outcomes, and demonstrating value will be essential.
Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: Commitment to demonstrating value and proven outcomes. Thriving practices will show they’re helping patients through data and not just high volume, but genuine clinical benefit with appropriate utilization. They’ll integrate conservative care pathways because that’s what patients need, not just what’s procedurally profitable. Surgeons leading these practices will embrace transparency because they’re confident in their results and committed to continuous improvement. They’ll leverage AI and analytics not to replace clinical judgment but to support better decision-making and prove they’re delivering value to payers and employers. These practices will be deeply satisfying places to work because everyone shares a mission of excellent patient care. Struggling practices will be those still operating on volume-based models because payment systems haven’t evolved, or because they lack the infrastructure to demonstrate quality. The distinguishing factor is adaptability and willingness to work within value-based frameworks that, done right, should reward physicians who’ve always tried to do the right thing.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Introductory thoughts lean towards the obvious, a dependable and enduring archive of specialty consultations and workload. Establishing this brand of business, if you will, requires years of relationship building mixed with expectant outcomes both witnessed and trusted over time. Affability and accountability in person and practice continue to apply. Having been fortunate enough to practice in one local for decades has facilitated and nurtured these referral patterns.
