Spine code bundling led to limiting procedures at some facilities + 2 more trends from Dr. Jocelyn Idema

Spine

Jocelyn Idema, DO, is an orthopedic spine surgeon serving the greater South Hills of Pittsburgh and Washington, Pa., areas.

She has a special interest in minimally invasive spine surgery and motion preservation. Dr. Idema has built her career on providing evidence-based medicine and developing a successful private practice. Here, she discusses the biggest healthcare and business trends that will affect her practice in the coming year.

Question: What are the three biggest business or healthcare trends you expect to affect your practice in 2019?

Dr. Jocelyn Idema: Although there are many trends that could affect my practice in 2019, I find that the continual struggle with insurance companies continues to be an issue for both patient and provider alike. Many insurance companies continue to bundle and/or narrow procedures that can be done, as well as where the procedures can be done. As a result, many of my colleagues and I end up having to carry privileges at multiple hospitals and surgery centers in order to accommodate where procedures are allowed to be done.

The second biggest trend that I see affecting my practice will be bundling of payments. Our spine team is continually working to stay on top of the latest changes with regard to bundling. For example, what used to be three separate codes for reimbursement is now one, thus this allows for decreased reimbursement to not only the physician but the facility as well. I have found that some facilities because of these changes, are now limiting the numbers of those types of surgeries to be done.

Finally, in the private and independent sector where I operate, changes and high turnover of staff continues to work against developing great teams. I fortunately continue to work with the same staff, however we have recognized the need to cross-train all members so that they may fill-in as necessary. Building a great team is key to continuing to thrive in this type of environment and medical climate.

Q: Where do you see the best opportunities to grow?

JI: I see the best opportunities for growth are in the outpatient spine sector. I feel as though the surgical culture continues to move towards patient-centered healthcare, and thus we can really work out a lot of issues before and after surgery in the comfort of the patient's own homes. By utilizing home health and therapy teams effectively in the patient-centered mindset, I am beginning to see a lot of opportunity in telehealth and reaching out to patients across the country, but also when you can't wait for an appointment in four to six weeks. With videotaped exams we can at least initiate treatment electronically with PT, medications and ordering of X-rays, and then bring you in for a face-to-face follow-up appointment later. I do know of a few companies that are starting to work towards providing these types of services for patients.

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