5 Ways to Capitalize on Outpatient Spine Surgery

Practice Management

Here are five ways to capitalize on outpatient spine surgery at surgery centers.

1. Market yourself as a leader in your community.
Since spine surgery is relatively new in the outpatient setting, marketing these services gives the ASC a strategic advantage in the community. "Depending on the market you're in, if you're looking to be on the forefront of technology as it develops, advertising your outpatient spine capabilities can help solidify your reputation as a market leader," says Dan Beuerlein, regional vice president of operations at Symbion Healthcare. Sometimes, people might be weary of undergoing spine surgery at an ASC, so listing complimentary specialties, such as pain management and orthopedic surgery, in the marketing literature earns credibility among potential patients. "You are showing the ASC is capable of handing this complex specialty," says Mr. Beuerlein.

2. Cater to new patient acquisition channels.
Practices should find a niche of patients to serve within their community and heavily pursue those cases, whether they are the Medicare population or workers' compensation patients, says Jimmy St. Louis, senior vice president of corporate operations at Laser Spine Institute. Laser Spine Institute regularly works with new partners who can facilitate surgeries to Laser Spine Institute. Laser Spine Institute is a good fit for patients who injure their back and spine on the job because minimally invasive surgery returns patients to their normal activity and job quicker than traditional open surgery.

Mr. St. Louis says collaborating with the workers' compensation population and the personal injury is beneficial because these patients pursue more surgery integrated with conservative treatment.

3. Keep outpatient spine-focused surgery centers small. Size matters when it comes to spine-focused ASCs, says Jeff Leland, CEO, Blue Chip Surgical Center Partners. But that doesn't mean bigger is always better. In our experience, the strongest business cases often involve small centers with 1-2 operating rooms. Overbuilding remains a real risk in the outpatient spine market. It's more important to master case volume and case payor mix. Volume is all about surgeon-partners delivering the cases they projected to bring, while the right case payor mix will vary by market and payor environment, though it may include pain management and orthopedic procedures.

4. Effectively recruit spine surgeons. Surgeons practicing specialties traditionally found today in ASCs have most likely been recruited by multiple facilities during their career, which makes it difficult to formulate an enticing recruiting strategy for them. "What you're doing is hoping to find, for example, young ENTs who are new to the market or potentially an ENT practice that is backing out from a center they are not happy in," says Chris Bishop, partner and senior vice president of acquisitions for Blue Chip Surgical Center Partners. This does not hold true for spine. "An advantage to recruiting spine is most spine surgeons still are not involved or haven't yet invested in ASCs."

 

There are several important things Mr. Bishop says ASCs should know about spine surgeons, which encompasses both orthopedic spine as well as neurosurgical spine surgeons. "They have slightly different training programs but what happening is there's now quite a bit of overlap," he says. "It used to be that an orthopedic surgeon would train to be an orthopedist and then specialize in spine, which meant that when he started his spine practice, he would potentially still do some orthopedics. Neurosurgeons began by really focusing a lot on the brain and the upper part of the spine but have now shifted down. So you have neurosurgeons with a brain-down approach and orthopedists have become a bottom-up approach."

 

While these two groups of surgeons have sometimes struggled to work together, Mr. Bishop says a melding between them is occurring in ASCs as they begin to understand the benefits of collaborating as investment partners. The groups are finding that their techniques are more similar than they realize and they've become more comfortable agreeing upon the same equipment needs, he says, which further enhances the appeal of working together in an ASC.



5. Show your setting is appropriate during payor contract negotiations. Insurers will always note that spine procedures are not in the Medicare-approved list for outpatient surgery. "You have got to prove these procedures can be done safely outside of the hospital," says Matt Searles, a managing partner at Merritt Healthcare in Somers, N.Y.. For a particular procedure, demonstrate that your spine patients do not have to be sent to the ED, that there were little or no overnight stays (which are possible in 23-hour facilities) and that the center's infection rate is lower than the hospital's. Payors also need to be persuaded that your center reflects the ASC industry's great reputation for efficiency. "Bombard the payor with data," Mr. Searles advises, "but don't be obnoxious, of course."

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