Two spine surgeons discuss healthcare consolidation and its effect on the spine arena.
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Question: What do you think about consolidation in healthcare and how will it affect spine surgeons over the next two to three years?
Christian Zimmerman, MD. Spinal Neurosurgeon at Saint Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Frankly, the consolidation efforts of corporate healthcare may have reached its apex, short of freestanding surgery centers being purchased as a profit center. The prohibitive outlay will be bringing these centers up to quality control metrics that follow Medicare standards. This will include peer-review and cost per unit evaluations, standardized certifications for all members delivering care and elimination of balance billing. Those efforts may be undesired and unobtainable by investors and will require physician participation to incorporate these practices into mainstream hospital formulates.
There is a significant push in this local to eliminate contractual physician agreements because of Medicare reductions and DRG deteriorations. This may positively impact those surgical disciplines that currently enjoy better reimbursements to hospitals and centers. Uncertainty remains the only constant, and second guessing our political overbalance are administrative poker at best. Good work and patient representation hopefully outlast the guessing game of healthcare futures.
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: The funny thing about consolidation is it does the exact opposite of what the original intent of the ACA was supposed to produce. In driving surgeons into employed positions and larger organizations gobbling up other ones, it does not take an economist to figure out prices are going to rise again. Consolidation will put us right back in the pre-ACA era and with legislators looking to tighten the screws on these larger organizations and these individual surgeons, who thought they had a great deal, will feel the pinch. I sincerely hope the nadir of this slope is coming and we will once again have some sense of direction, self and safety.