How 4 spine practices are leveraging outcomes and payment data

Practice Management

Data that tracks patient satisfaction and clinical outcomes empowers physicians to objectively demonstrate care quality and value during payer and partner negotiations.

Compiling information on what patients say about the care they receive allows practices to assess patients' satisfaction with their care, progress toward their goals and overall feelings about whether their health or condition has improved.

Four spine surgeons outline how outcomes and payment data are collected and leveraged at their respective practices.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.

Next week's question: How has the payer landscape evolved in your market over the last five years? What do you expect in the future?

Please send responses to Alan Condon at acondon@beckershealthcare.com by 5 p.m. CST Wednesday, Feb. 23.

Editor's note: The following responses were lightly edited for style and clarity.

Question: How is your practice collecting/sharing clinical outcomes and payment data?

Robert Bray Jr., MD. DISC Sports & Spine Center (Newport Beach, Calif.): At DISC, we collect data for all of our clinic and outpatient events done at the surgery center. We consolidate the billing records through HST and our medical records via DrChrono. We are developing new algorithms to loop the cost-effectiveness of the case on the quality assurance point of view. To do so, we link the decision making of the surgeon over time with the case selection and then review both the cost of that care and the clinical outcome via patient-derived data. This allows us to determine whether the medical care delivered is truly a cost-effective, patient-centered clinical decision.

Michael Goldsmith, MD. The Centers for Advanced Orthopaedics (Bethesda, Md.): We collect clinical outcomes in a variety of ways for patients who are not in a particular study. For our surgical patients, we do routine preoperative assessments and follow these patients after two, six and 12 weeks, and then again after six and 12 months. We typically do a disability index with the Oswestry Disability Index, the SF-36 short form health survey and visual analog scales for pain. We have a robust electronic medical record system that enables us to collect this data. We have harmonized our EMR across all of our care centers so this data can be easily pooled and presented through our clinical subcommittees — specifically spine — to collate the information and share it amongst our physicians. In addition, I run a monthly [morbidity and mortality] conference to help identify and learn from any complications that may arise from surgery. Finally, we are involved on a state level in an initiative called Episode Quality Improvement Program that helps us follow our costs via payments through an episode-based approach. 

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: At this point, we are collecting our own outcomes data for its own sake. We are fully aware that payers at the end of the day are looking for any reason to pay you less, and really don't intend on paying more for good outcomes. We let our outcomes, patient satisfaction and reviews and patient-to-patient referrals be their own data and outcomes.

Richard Kube, MD. Prairie Spine (Peoria, Ill.): Payments are easy as we have published cash prices online for several years. We have posters at our lobby entrance as well as rack cards at the counter. For outcomes, we assimilate data for never-event rates, clinical outcomes scores and the like. We post those items as well as patient satisfaction with our welcome packets and on our surgical suite website. COVID has us behind in some posting, but patients and payers have access to our numbers.

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