The next 5 years for spine surgery in ASCs: Key thoughts from Dr. Frank Phillips


Frank Phillips, MD, co-founder of the Minimally Invasive Spine Institute at Midwest Orthopaedics at Rush in Chicago discusses the future of spine in ASCs and where the biggest opportunities for outpatient spine will be in the next five years.
Dr. Phillips is speaking on a panel about the future of spine and ASCs at the Becker’s 15th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine on June 22 to 24, 2017 in Chicago. Click here to learn more and register.

Question: How do you see spine evolving in ASCs over the next five years? How will they change and how will they stay the same? 
Dr. Frank Phillips: There will be continued expansion of spine procedures in the ASC environment. With the advent of improved anesthesia and more reliable postoperative analgesic strategies, more complex spinal procedures will migrate to ASCs. Already we and others are routinely performing lumbar and cervical fusions as outpatients in an ASC setting. The efficiencies and cost-effectiveness when compared to traditional hospitals will continue to drive this. With this inevitable migration to outpatient surgery, hospitals/hospital systems and surgeons will be required to partner in creating ASC opportunities. When done appropriately this creates aligned incentives for all stakeholders.  
Q: What opportunities are there for spine surgeons to expand their outpatient ASC and practice?  
FP: There are still many instances where spine surgeons do not have relationships, incentives or ready access to focused ASCs. This is particularly the case in academic, university-based programs where large hospitals have been the backbone of the relationship. I would suggest that these practices need to explore ASC opportunities, often by necessity in partnership with their affiliated hospitals, to provide the most appropriate venue for spinal procedures. Spine surgeons interested in expanding procedures in the ASC, should work closely with the center to establish safe and reliable patient care pathways to ensure excellent patient care.
Q: What do spine surgeons need to know about payers and reimbursement for their procedures in ASCs? 
FP: This is an area where considerable effort is required. Complex spine procedures are expensive and resource intensive and without appropriate contract negotiations and developing carve-outs for implant and biologics, these procedures are not sustainable in the ASC. The demonstrable cost savings realized in the ASC environment, will however bring payers to the negotiating table.

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