5 key recommendations for payer reform in spine surgery

Written by Laura Dyrda | June 09, 2017 | Print  |

A new article published in Clinical Spine Surgery examines payer reform opportunities for spine surgery.


The article, written by Jason Scalise, MD, and David Jacofsky, MD, focuses on bundled payments. Here are five key trends from the report:


1. Spine is facing increased payer scrutiny because the number of spinal procedures is expected to increase in the near future and the fee-for-service payment system is unsustainable. As a result, payers are turning to value- and risk-based contracting for episodes of care.


2. CMS has shown bundled payments can effectively increase quality and decrease costs for joint replacement bundled payments, and progressive payers are seeing success with spine surgery bundles as well.


3. Pressure to provide cost-effective and quality care are forcing hospitals and physicians to align with payers and reduce costs through new relationships. While progress is clear, the article's authors posit spine surgery is "years behind the wave of market pressures seen in other orthopedic specialties."


4. Bundled payment programs typically include a flat rate for 90-day episodes of care, including any surgical procedures, rehabilitation and follow-up care.


5. The article authors recommend surgeons recognize the forces driving the value-based contracting trends to "adapt and ultimately master such transformations."


More articles on spine surgery:
5 spine surgeons share advice for thriving in private practice
Total disc replacement vs. rehabilitation for low back pain: 6 things to know
Posterior vs. anterior & posterior approach for severe scoliosis treatments

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