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. We invite all spine surgeon and specialist responses. Next week’s question: What is the most underrated quality of a great spine surgeon?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, March 25, at 5 p.m. CST.
Question: What can spine surgeons do to alleviate the effects of declining reimbursement on their practices?
Brian R. Gantwerker, MD, The Craniospinal Center of Los Angeles: I believe strategic partnerships with surgery centers, other surgeons and other similar practitioners can help cut costs. Some surgeons are switching over to a concierge-type model, similar to those of our internal medicine colleagues. While attractive, it can have serious repercussions on your referral pool. If you are in a heavily managed care practice, it will continue to be difficult. But benchmarking and high quality outcomes can keep your edge on the reimbursement side.
Richard A. Kube II, MD, CEO, Founder, Prairie Spine & Pain Institute, Peoria, Ill.: Surgeons have to act like any other business and attack the cost side of the equation as much as the reimbursement side.
Anthony Yeung, MD, Desert Institute for Spine Care, Phoenix: Most independent practices will merge with other 
spine groups that in turn will align with large healthcare entities with a strong presence in their community.
They will collect data to show that the group offers the full spectrum of care with the least complications, above average outcomes and the greatest patient satisfaction.
While this strategy may garner increased reimbursement with payers in large metropolitan areas, there will still be “superstar” groups or individuals who can survive by not having to depend on payers, and are able to attract medical tourism and offer methods and techniques that provide care recognized to be the best designed for each individual patient.
This care must rise above the marketing hype, delivering results consistently enough so that the surgeon can essentially warranty their results and deliver the care at results above and costs below what the coalitions can deliver.
Surgeons will have to distinguish themselves, like professional athletes, recognized for their individual or group skills and their ability to deliver expected results.
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