Hospitals weigh options as orthopedic practices attract patients

Practice Management

In the last year, spine and orthopedic practices have turned to consolidation and aligning with management services organizations to keep up with the shifting healthcare landscape. For patients, outpatient surgeries and forgoing hospital stays have become favorable, especially during the COVID-19 pandemic.

Where does that leave hospitals? Private practices and outpatient-care facilities have been helpful as hospitals faced staffing shortages during the COVID-19 pandemic. 

In 2021, there were five major spine and orthopedic tower developments either in the works or opening. They include Huntsville (Ala.) Hospital's $150 million orthopedic and spine tower, a $120 million tower under construction for Lubbock, Texas-based Covenant Medical Center and Rochester, N.Y.-based UR Medicine's $240 million tower in the works.

Specialized spine and orthopedic centers could help hospitals remain competitive. But key factors that could make or break the success of these centers will be their outpatient capabilities and costs. 

When considering the future of spine surgery, Adam Bruggeman, MD, of San Antonio-based Texas Spine Care Center, said overcoming reimbursement differences is necessary to stay competitive.

"Hospitals have negotiated against surgery centers for decades, leading to a dramatic difference in hospital, hospital outpatient department and ASC reimbursement," Dr. Bruggeman told Becker's. "These practices and policies are driving a significant component of the outpatient migration, in addition to legislation that prevents new physician-owned hospitals from being developed de novo. Physicians will be the new drivers of healthcare for the next decade in terms of bundles and at-risk payments. Hospitals will need to find a way to bring their costs into bundles that make sense for the physicians who manage these arrangements."

Alok Sharan, MD, a spine surgeon at NJ Spine and Wellness in East Brunswick, N.J., said hospitals can keep up with the changing healthcare landscape by adapting to the need for outpatient care.

"Hospitals must understand, like every business, that change is the only constant," he told Becker's. "The traditional hospital business model of making revenue through inpatient admissions will exist, but in limited form. The future model of care will be outpatient-focused factories that merge specialized centers of excellence with outpatient ASCs. The migration of cases to the outpatient space should encourage hospitals to rethink their business models and invest in capabilities which can achieve these goals."

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