Although some spine surgeons have found success with dropping insurers and CMS, other physicians say it isn’t the best choice.
Two spine surgeons discuss the realities of what the move could mean for spine surgeons.
Note: This response was lightly edited.
Question: Regardless of your own approach, can cutting ties with insurers and/or Medicare be a feasible option for spine surgeons? What considerations should physicians weigh?
Timur Urakov, MD. University of Miami: As someone working on the academic side, I can certainly relate to the frustrations many surgeons face when dealing with insurance companies. It often feels like we’re caught in an endless loop of denials and delays due to arbitrary checkmarks on some imaginary checklist, which inevitably hinders patient care. The constant back-and-forth can strain relationships and lead to a sense of wanting to break free from these constraints.
However, it’s essential to remember that at the heart of this issue are the patients, who are waiting for the care they need. It’s not their fault that the insurance companies are not providing the necessary support. We must be cautious before deciding to stop providing care to a specific group or population based on their insurance provider. Their well-being should always remain our primary concern.
On the flip side, while empathy and compassion are crucial, they do not pay the bills. There comes a point when we must be willing to walk away from a bad deal if it means preserving our ability to provide quality care. It’s a delicate balance to strike, and it requires careful consideration.
Ultimately, continuing collaboration among physicians as a unified voice is essential. By working together, we can advocate for better conditions and ensure that our patients receive the care they deserve.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): The action of opting out of any insurance or contractual plan may have an enhanced, long-lasting and detrimental reaction to one’s practice and reputation, especially given the current climate of reduced payments and scrutinous oversight. It can affect downstream referral patterns, scheduling lapses and create ill will amongst colleague providers viewed as a form of cherry-picking. It is never the better that gets dropped or removed, but the most cumbersome or lacking within a payer system. Being a provider who takes the good with the bad, both personally and professionally, is a well-accepted, tried and true methodology acknowledged when practiced, either privately or under an employed model. It has certainly changed the scales of insurance indices and referral volumes but also provides a significant opportunity for those who are systemically unvirtuous or unblameably refuse to care for the more complex patient.
