Spine care will have to change under value-based model, 1 surgeon says

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The popularity of value-based payment models has risen in recent years among physicians and patients — though not unanimously. The divide has caused certain specialties to embrace the care model more willingly than others, prompting the question: What does the growing emphasis on value in healthcare mean for spine surgeons?

Philip Louie, MD, a spine surgeon and medical director of research and academics at Virginia Mason Franciscan Health's Center for Neurosciences and Spine in Seattle, recently joined Becker's to share his insights on what is to come for spine care.

Editor's note: Responses have been lightly edited for length and clarity. If you would like to contribute to our next question, please email Paige Haeffele at phaeffele@beckershealthcare.com.

Question: What are you most proud of in the last year?

Dr. Philip Louie: Our spine team has been incredibly resilient this past year despite the significant staffing shortages, financial stressors and organizational changes. The incredible clinical and academic growth has been a result of the dedication of so many crucial team members.

Clinically, we have expanded our surgical techniques, improved access at suburban regional sites and revamped our ability to engage patients through visit recordings, informational videos, and messaging systems providing ongoing perioperative care instructions. As chaos surrounds us, we are finding different ways to improve patient care in multiple phases.

Academically, we have grown our mentorship and research programs to include students of various levels of training and developed a consistent regional Seattle-area spine journal club that includes more than 10 spine groups and medical centers. Students, trainees, advanced practice providers and staff members have participated in several research endeavors and have had opportunities to present at national and international conferences. Grant awards have been cherries on top.

Q: What are the biggest trends you're following in healthcare right now?

PL: The consolidation of healthcare as a whole: Much like how we have seen much of the business world consolidate their brick-and-mortar physical working spaces and schedules, healthcare will require innovation to redesign how we package the care that we deliver. 

The rapid rise of enabling technologies: The goal of these innovations is to improve the way we care for patients and ultimately drive meaningful change in how we practice. As multiple companies work towards an "all-in-one" combination of various pre-op planning tools, augmented reality, surgical robot/navigation and collection of postoperative outcomes, we hope that these tools will guide us through the whole perioperative episode and provide us with crucial data on our planning and results.

The expansion of outpatient procedures in ASCs: The past decade has shown us that orthopedic and spine surgery (in the properly indicated patient) can be performed in a safer, more efficient and cost-saving manner compared to the traditional large hospital setting. This migration of surgeries to the ambulatory surgery centers and other outpatient centers have been fueled by the innovation of several enabling technologies. With ongoing financial stressors of large hospital systems and patients' concerns with hospitals, the ability to expand technologies to aid safe surgeries in outpatient settings will be paramount. Understanding how this all plays out in a landscape trying to become more value-based will be interesting to be a part of.

Q: What are you excited about for 2024?

PL: As a field, I am excited to see how we improve our understanding of how ASCs fit into the value-based care equation that is dominating our healthcare landscape. Patient care and outcomes will always be the most important factor. But in a world where we are seeing a shift to value-based healthcare and reimbursement, we will also need to reevaluate how spine surgical care is delivered and billed. In this upcoming year, I think we will all develop new evidence to disseminate the safety, efficacy and the economic factors are underway.

As a spine team, we have ambitious plans to incorporate additional patient care pathways and newer surgical techniques. We have various staff members leading and engaged in many different projects and I cannot wait to see how they foster their passions and grow our ability to provide exceptional spine care.

Personally, I am excited for the opportunity to serve as co-program chairs of the Safety and Spine Summit as well as the Society for Minimally Invasive Spine Surgery Annual Forum. Contributing the knowledge sharing, collaborations and education of my colleagues has always been an area of my work that I enjoy.

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