Historically, growth in spine care was relatively straightforward. Perform more procedures. Build more operating rooms. Expand access to new technologies. Increase volume. A growing number of spine leaders believe that formula is becoming outdated.
At Becker’s 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC Conference in Chicago, physicians described a healthcare landscape increasingly defined by a different expectation: proving value.
The shift is being driven by rising healthcare costs, value-based reimbursement models, the continued migration of procedures into ASCs and growing scrutiny from payers, employers and patients.
For clinicians, the implications are significant. Success is no longer determined solely by how much care is delivered. Increasingly, it is determined by whether organizations can demonstrate that the care they deliver produces measurable outcomes at an appropriate cost.
“Value-based care is all based on data,” Ramis Gheith, MD, chief medical officer of Chicago-based DxTx Pain & Spine, said. “Collect your data now. Start now if you haven’t started already.”
For many organizations, that transition is already underway.
The growth opportunity most spine practices overlook
Healthcare leaders often focus on increasing surgical volume. Aqib Zehri, MD, a neurosurgeon at The Oregon Clinic in Portland, believes many organizations are overlooking a more fundamental challenge. Referral management. The observation reflects a reality facing many spine practices. Before a patient ever reaches an operating room, they must successfully navigate scheduling, evaluation, imaging, insurance authorization and specialist consultation.
Every delay creates friction. Every handoff creates risk. Every inefficiency increases the chance that a patient seeks care elsewhere. While hospitals and physician groups frequently invest in robotics, navigation platforms and new procedural capabilities, Dr. Zehri argued that growth often begins much earlier in the patient journey.
“I think physicians are focused on trying to drive surgical volume,” he said. “But I think that starts way ahead of that.”
The comment underscores a broader shift occurring throughout healthcare. Operational efficiency is increasingly becoming a competitive advantage.
Why definitive care is becoming more important
For decades, many spine and pain patients progressed through a series of interventions before reaching a more definitive treatment strategy. As value-based reimbursement expands, Dr. Gheith believes that approach may become more difficult to justify.
“We’re going to go straight to definitive care measures, going forward,” he said. The economics are changing. Payers are increasingly evaluating episodes of care rather than individual procedures. Employers are demanding greater accountability. Patients are becoming more informed about treatment options and expected outcomes.
As a result, healthcare organizations are facing greater pressure to demonstrate that interventions produce durable results rather than temporary improvements. The question is no longer simply whether a procedure works. The question is whether it creates meaningful value over time.
The ASC opportunity comes with new responsibilities
Few areas illustrate healthcare’s transformation more clearly than the continued migration of spine procedures into ASCs. The movement has created new opportunities for physicians while simultaneously raising new questions about patient selection, standardization and safety.
Steven Crider, MD, business owner and physician at Watkinsville, Ga.-based Origins Spine and Joint Physicians, believes that challenge deserves more attention.
“I think you’re probably going to have a lot of providers that are doing inappropriate cases in the ASC,” Dr. Crider said. “Meaning patients that are too sick to be there.”
As more procedures become eligible for outpatient settings, the distinction between innovation and overreach becomes increasingly important. The industry’s ability to expand outpatient spine care successfully may ultimately depend on maintaining discipline around patient selection.
For Dr. Zehri, another challenge involves consistency.
“It’s hard to standardize how those surgeries are done amongst different spine surgeons,” he said. That variability creates obstacles for organizations attempting to scale outpatient programs while maintaining predictable outcomes.
A reimbursement battle that could reshape spine care
Among the topics generating the strongest consensus was site-neutral payment reform. Supporters argue that paying similar rates for similar procedures regardless of setting could accelerate outpatient care while reducing overall healthcare spending. Dr. Gheith believes the implications extend beyond economics.
“What that really does is it puts power back to the doctors, the physicians, the surgeons and takes it away from the hospitals,” he said.
The impact is already becoming visible. As more procedures migrate into ASCs, hospitals are increasingly confronting a different patient mix. “The hospital is seeing more complex revision cases while more of the simpler cases are being pushed out,” Dr. Zehri said. That shift has significant implications for hospital margins, staffing models and long-term strategy.
Why data is becoming healthcare’s most valuable asset
The strongest message from the panel was not about reimbursement. It was not about ASCs. It was not about technology. It was about measurement. The leaders repeatedly returned to the same idea: organizations that cannot quantify outcomes, costs and value may struggle in the healthcare environment that is emerging.
“We’re not only collecting the data, but we’re sharing it,” Dr. Gheith said. “We can show that what we do not only improves outcomes, but brings value to the entire system in a high-quality, safe outpatient setting.”
For decades, healthcare largely rewarded volume. The future appears increasingly focused on something else. Proof.
Dr. Zehri captured the shift in a single observation. “The future of spine surgery isn’t about doing fewer surgeries or more surgeries,” he said. “It’s about delivering the right surgery for the right patient in the right setting.”
As value-based care continues expanding, that philosophy may become the defining standard for spine programs across the country. The organizations that thrive will not simply be the ones performing the most procedures. They will be the ones best equipped to prove those procedures matter.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
