Spine market is the biggest opportunity for growth, Hoag Orthopedic Institute CEO says

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Irvine, Calif.-based Hoag Orthopedic Institute has appointed Kim Mikes, BSN, RN, as its third consecutive female CEO.

Over the last five years, Ms. Mikes operated as chief operating officer and chief nursing officer at Hoag Orthopedic Institute, and she has served as interim CEO since May, when Jennifer Mitzner left the role.

Ms. Mikes spoke to Becker's about the biggest opportunities for growth in 2022, challenges facing orthopedic practices and the qualities healthcare leaders need to succeed.

Note: Responses are lightly edited for style and clarity.

Question: What do you see as the most pressing issue facing independent orthopedic practices in 2022?

Kim Mikes: As large numbers of orthopedic practices consolidate under national health organizations, independent orthopedic practices may lose access to patients who will be directed to affiliated surgeons. Practice overhead costs have also grown due to the COVID-19 pandemic. There is a shortage of healthcare workers, and those who are looking for employment are looking for a higher rate of pay.  

Q: What are the top healthcare trends you're following?  

KM: 1) Consolidation of physician practices: Mega groups and consolidation under corporate umbrella companies. 

2) The CMS transition of orthopedic procedures such as total joint and spine from the hospital to the ASC, and the subsequent reversal of those guidelines for certain procedures to go back to the hospital instead of the ASC.

3) Orthopedic population health management.

Q: Where are Hoag Orthopedic Institute's biggest opportunities for growth in 2022?  

KM: As one of the largest providers of orthopedic care in the Western region of the U.S., Hoag Orthopedic Institute has the opportunity to enhance our efforts to highlight what differentiates us in our markets. We are an orthopedic and spine specialty hospital and ASC network. Our team of physicians and staff members are experts at orthopedic and spine care. With that expertise comes all the benefits of quality outcomes, high volume, standardized value-based care and low infection rates. We need to ensure that the Southern California community knows that Hoag Orthopedic Institute is where you come for orthopedic and spine care. We are also increasing our ability to take care of higher-acuity orthopedic and spine patients. Our biggest growth opportunity will be in the higher-acuity spine market.  

Q: What skills are critical for healthcare CEOs to thrive in today's environment? 

KM: I believe that having both a clinical and business background is extremely beneficial in leading a healthcare organization. Being able to look at an issue and make operational and strategic decisions with both a clinical/quality and a financial lens is invaluable. It enables you to "talk the language" of both clinical and financial team members and physicians, garnering credibility and respect. It is also critical to stay informed of healthcare trends and to be able to quickly make changes. Understanding the business at its core allows for rapid execution when needed.  

Q: How do you expect orthopedic care delivery to change in the next five years? 

KM: In the next five years, we will see a significant increase in the number of orthopedic procedures done in the ASC setting. There will continue to be a large number of patients who will more safely be treated in the hospital setting. We will also likely see more orthopedic care being delivered in a risk-based population management model. 

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