From the operating room to stakeholder collaboration, innovations in the spine industry are emerging from multiple avenues in the healthcare landscape.
The 17 leaders featured in this article are speaking at Becker’s 22nd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, set for June 18-21 at the Swissotel Chicago.
If you would like to join the event as a speaker, please contact Carly Behm at cbehm@beckershealthcare.com.
As part of an ongoing series, Becker’s is connecting with healthcare leaders who will speak at the event to get their insight on thought-provoking questions within the industry. The following are answers from event speakers, lightly edited for clarity.
Question: Where are the best ideas in spine and orthopedics coming from right now?
Caleb Ashmore, PT, DPT. Orthopedic rehabilitation services supervisor at Harris Health System (Bellaire, Texas): Great research comes out every day, but you have to take the results of the studies with a grain of salt. The reason for this is that many of the studies are not well done. Most of them are underpowered, or the design of the study was not prospectively planned in a way that is sound or conducted without bias. Many of the studies are not able to make the bold claims that they make by the end of the paper, but they make them anyway in order to get published. Unfortunately, some of the most rigorously done studies never see the light of day because they took all of the right steps but didn’t get a “sexy” outcome that would go viral on social media. This needs to change in order for spine and orthopedics research to improve, moving forward.
Ashley Bennett, RN. Quality director at Surgery Center-Germantown (Tenn.): The best ideas in spine and orthopedics right now are coming from the integration of AI and personalized medicine. AI is enabling a shift toward highly individualized care by analyzing patient-specific data to create custom surgical plans, implants, and recovery pathways. These innovations — driven by startups, medtech companies and research institutions — are improving precision, reducing complications, and enhancing patient outcomes, setting a new standard for orthopedic and spine care.
Michael Boblitz. CEO at Athens (Ga.) Orthopedic Clinic: Employers remain frustrated with a fragmented healthcare system that lacks coordination between payers, providers and suppliers. Market forces continue to push innovations that align incentives across industries to disrupt the status quo. The employers – via the payers – are similar to a traditional consumer where price matters. Healthcare providers, orthopedic practices and hospital bases orthopedic service lines are commodities — with employers seeking lower cost alternatives.
Payers are recognizing the implants are contributing to higher healthcare costs and introducing new contracts that transition away from “cost plus” reimbursement. Implant costs have been inflated for years in exchange with “rebates” that reward ambulatory surgery centers for utilizing higher cost products. New payer proposals include increasing facility rates in exchange for ASCs eliminating the inflated rebate-driven prices. This can create a net positive to private orthopedic practices that operate ASCs via aggressive negotiations with vendors that are hungry to capture market share — at prices below current market rates. A great approach to help reverse the rapidly rising cost of healthcare for employers.
At the same time, new companies continue to expand rapidly that link employers to private orthopedic practices with wholly owned ambulatory surgery centers. These NewCo models stall in JV ASCs where the facility is controlled by a separate firm than the practice. Athens Orthopedic Clinic operates wholly owned ASCs that offers employers simple bundled pricing that combines the Facility Fee, the Anesthesia Fee and the physician fee in one invoice — significantly below higher cost hospital-based pricing. In addition, AOC is expanding beyond the surgical episode to offer employers direct pricing for access to Northeast Georgia’s only orthopedic urgent care centers that operate seven days per week, a network of MRI/CT Centers, and a robust outpatient therapy network with over 46 providers. This broader approach expands the aim with a laser focus on access, prevention and recovery — while allowing the contracted beneficiaries to avoid expensive hospital care.
Orthopedics now ranks second in the US.. in total cost of care — behind oncology and ahead of cardiovascular disease. A big cost driver is back pain and arthritis/joint replacement. The cost for a spine surgery or a joint replacement surgery is at least 40% more expensive in the hospital setting. payers are becoming more innovative via “carve outs” in these higher cost conditions to allow private orthopedic practices to transition these patients into the ambulatory surgery setting. Limited reimbursements for these higher cost conditions have traditionally kept these cases in the hospital outpatient setting. A financially viable ASC can invest in extended care capabilities and robotics to replicate the traditional hospital environment — at a fraction of the cost.
Lastly, large private orthopedic practices like AOC have significant supply costs that warrants an aggressive supply chain strategy. This focus eliminates waste in practice expenses to fund expansion projects and further drive market share away from higher cost settings and providers. AOC is negotiating large price reductions in DME, installing best in class automated inventory management systems, and partnering with the largest GPO in the U.S. The aim — to drive costs fast and grow.
These cross-industry approaches are making improvements in the overall cost of care. AOC is working hard to support the business community with a comprehensive orthopedic platform that cared for 232,000 patients served last year alone. We have served Georgia for 60 years and even more excited for the next 60 years.
Cynthia Burleson. Administrator at Brunswick Surgery Center (Leland, N.C.): The use of minimally invasive techniques has been shown to reduce stress and impact on the body. With robotics being used more for joint and spine procedures, in addition with the use of artificial intelligence will continue to aid in smaller incisions, less manipulation and faster recovery times, creating a growing market for ambulatory surgical care.
Janet Carlson, MSN, RN. Vice president of ASC operations at Commonwealth Pain & Spine (Louisville, Ky.): The best ideas in spine and orthopedics come from three important ASC stakeholders to enhance a patient’s surgical outcomes. The first is from my surgeons, they are attending (often speaking at) professional conferences and connecting with colleagues across the nation and with their international peers. These conversations are very impactful on improvements and best practices for surgery. The second is from members of my ASC clinical team, like my surgeons, they are also attending important conferences where they are introduced to new techniques, devices, products and software solutions. The third stakeholder imperative to sharing the best orthopedic and spine ideas, the vendor representatives I partner with in our ASCs. Any information that improves the safety, quality of surgery and operational efficiency (as well as the patient experience undergoing surgery) are welcomed and highly encouraged.
Alfonso del Granado. Administrator and CEO at Covenant High Plains Surgery Centers in Lubbock, Texas: The best ideas in spine and orthopedics continue to come from our surgeons! Some are more attuned to the latest developments, others are more cautious, and balancing the two perspectives from both a clinical and a financial perspective can be tricky sometimes. Right now I’m surprised by the slow adoption of endoscopic spine surgery. Although costs remain high, reimbursements can be challenging, and patient selection is critical, this is still a good way for surgeons — and surgery centers — to differentiate themselves from competitors. I would not suggest that an ASC operating at full capacity should replace higher-margin cases with endo spine procedures, but if the ASC is underutilized, staffing is appropriate, and anesthesia is available, then endo spine can be a good fit. I realize there are a lot of “ifs” in that last sentence, but that is always true of any new procedure. This is just one of many ideas brought to my attention by an engaged surgeon who became the program champion — an essential element to ensure success in any new procedure or service line.
Ali Ghalayini. Administrator at Advanced Spine Center of Wisconsin (Neenah): Ambulatory surgery centers (ASCs) are rapidly emerging as the new frontier for complex spine and joint procedures. What was once limited to the hospital setting is now safely and effectively being performed in outpatient environments, thanks to advancements in minimally invasive surgical techniques, regional anesthesia, and enhanced recovery protocols. These developments are not only improving clinical outcomes but also reshaping how and where musculoskeletal care is delivered.
Central to this shift is the integration of Enhanced Recovery After Surgery (ERAS) protocols, which streamline pre- and post-operative care through multimodal pain management, early mobilization, and patient education. These evidence-based pathways significantly reduce complications and support same-day discharge, even for procedures like lumbar fusions or total joint replacements. At the same time, improvements in anesthesia — particularly regional blocks and opioid-sparing regimens — have made it possible to control pain more effectively without compromising alertness or mobility.
The benefits are multifaceted. Patients enjoy shorter stays, quicker recoveries, and the comfort of healing at home. From a financial perspective, ASCs deliver procedures at a significantly lower cost — often 30% to 50% less than traditional hospital settings — creating value for both payers and employers. For providers, outpatient settings offer greater scheduling flexibility, streamlined operations, and the opportunity to scale services efficiently while maintaining high-quality outcomes.
Looking ahead, the migration of complex orthopedic and spine cases to ASCs is expected to accelerate. With CMS and commercial insurers removing barriers and supporting value-based models, and with patient demand for convenient, lower-cost care continuing to rise, forward-thinking ASCs that invest in the right infrastructure and clinical protocols will be well-positioned to lead the future of outpatient musculoskeletal care.
Stephen Holtzclaw, MD. CEO of U.S. Orthopaedic Partners: The most impactful ideas in our field are coming from physicians who listen closely to patients and collaborate with peers to solve real clinical challenges. Innovation thrives when leading practices are connected and sharing insights across markets. Dr. Jeff Dugas’ InternalBrace procedure is a powerful example—born from conversations with colleagues and now transforming the way we treat elbow injuries. At USOP, we’re building a physician-led network designed to support and accelerate this kind of breakthrough.
Severko Hrywnak, MD, Chief Executive Officer, Advanced Ambulatory Surgical Center (Chicago): The best ideas in spine and orthopedic surgery are emerging from startup ecosystems. Health tech startups are rapidly innovating in areas like telemedicine, smart implants, and minimally invasive techniques, often driven by entrepreneurial spirit and a focus on patient-centered solutions.
Les Jebson. Regional administrator at Prisma Health (Greenville, S.C.): I think you’re going to see continued research and implementation of generative and agentic artificial intelligence[AI] solutions in orthopedics and spine care. Fundamentally, AI is starting to be adopted for tackling high-turnover clerical and administrative support positions. Specifically, high volume tasks such as patient registration, phone call management, prior-authorizations etc. Congruently, you will see AI utilized by the clinicians themselves to optimize EMR dictation and documentation. Finally, we will start to see AI continue to migrate into patient care support with clinical co-pilots helping with clinical decision making, surgical preparation and intraoperative assistance.
M. Craig McMains, MD. Spine surgeon at OrthoIndy (Indianapolis): The most innovative ideas in spine and orthopedics today emerge from physician-owned practices like OrthoIndy that combine patient-centered approaches with intergenerational collaboration and global knowledge exchange. Our physician ownership model eliminates bureaucratic barriers, allowing surgeons to directly implement technologies that address patient needs identified through daily clinical interactions. At OrthoIndy, breakthrough innovations flourish when our younger surgeons — bringing cutting-edge techniques in minimally invasive approaches and emerging technologies — collaborate with veteran surgeons who contribute decades of clinical wisdom and pattern recognition. This intergenerational synergy, embedded within our physician-owned structure and connected to global knowledge networks, creates a powerful innovation ecosystem that continuously advances spine care. Most importantly, our patient-focused culture ensures we evaluate innovations based on meaningful improvements to patient experiences and outcomes, not merely technological impressiveness.
Mick Perez-Cruet, MD. Professor and Vice Chairman of the Department of Neurosurgery at Oakland University William Beaumont School of Medicine and President and Founder of Michigan Minimally Invasive Neurosurgical Institute (Waterford): The best ideas in spine and orthopedic surgery continue to come from physicians active in clinical patient care. Advances in minimally invasive spine surgery that recycle the patient’s own bone from the surgical site to reduce cost while improving fusion rates is just one example. Other examples include awake complex minimally invasive spine surgery. This technique avoids many of the issues encountered with general anesthesia and allows fast recoveries and same day discharge. Spine surgeons are continuing to innovate to improve spine surgery that allows more patients to be treated on an outpatient bases, which reduces hospital cost and improves patient recoveries.
Melissa Rice. Administrator at Loyola Ambulatory Surgery Center (Oak Brook Terrace, Ill.): Some of the most innovative ideas in spine and orthopedics are emerging at the intersection of clinical expertise and advanced technology. We’re seeing groundbreaking work in areas like robotic-assisted surgery, biologics, and data-driven care models that improve outcomes and reduce costs. Collaboration between surgeons, device manufacturers, and ASCs is also driving meaningful innovation tailored to value-based care. The best ideas are often born from real-world challenges, with front-line clinicians and administrators leading the charge.
Elaina Turner, MSN, RN. Administrator at Advanced Surgical Institute New Albany (Ohio): I think that the greatest driver in advancements for spine and orthopedics today is technology advancements and outside the box thinking. The creativity and ingenuity of physicians drives them to come up with new and improved ideas for advancing the specialty. Using newer technology such as AI and virtual reality, training and testing can take place without the potential for harm.
Katherine Wagner, MD. Neurosurgeon at Ventura Neurosurgery: Some of the best ideas in spine and orthopedics are coming from clinicians and companies focused on motion preservation. We have had lumbar and cervical disc replacements for some time, and now surgeons have several great options for arthroplasty implants. The lumbar facet arthroplasty system TOPS is also gaining traction. This device is a promising tool for managing problems at L3-L4 and L4-L5, especially adjacent segment disease. These tools will let us recapitulate normal spinal anatomy for more patients.
There are also some exciting developments in navigation and augmented reality. As the footprint needed for each device gets smaller and the technology becomes more affordable we will be able to bring these devices into smaller ASC operating rooms and other facilities.
Connie Wilson, RN, MSN. Director of patient care services/nurse executive at Shriners Children’s Lexington (Ky.): The best ideas in spine and orthopedics right now aren’t coming from any one place — they’re coming from the edges. From the frontline staff, from entrepreneurial surgeons, from data scientists, from tech startups, from patients themselves. The future belongs to those who can connect the dots between care innovation, operational excellence, and human-centered leadership.
Graham Young. Senior vice president of mergers and acquisitions and business transformation at U.S. Orthopaedic Partners (Alpharetta, Ga.): Some of the best ideas in orthopedics today are coming from two forces: collaboration through consolidation and innovation from VC-backed startups. As practices align under physician-led models, we’re seeing smarter, faster sharing of ideas that improve care and efficiency. At the same time, startups—especially in AI and advanced data—are pushing new frontiers in surgical planning, diagnostics, and outcomes. The real progress happens when those two worlds come together.
