The COVID-19 pandemic has added to the economic difficulties of many private practices that were already in a cost-cutting mode to address the challenges of declining reimbursements and rising costs.
Three spine surgeons discuss what they are doing to deal with the financial challenges at their practices.
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 do you see as the biggest opportunities for spine practice at the moment?
Please send responses to Alan Condon at acondon@beckershealthcare.com by 5 p.m. CDT Wednesday, April 29.
Note: The following responses were lightly edited for style and clarity.
Question: What strategies have you implemented to address the financial challenges at your practice?
David Kaye, MD. Rothamn Orthopaedic Institute (Philadelphia): With increasing downward pressure on reimbursements, it is as important as ever to prove value in spine surgery. As spine surgeons, we know the value of our work; we see improvements in patients' lives daily. However, demonstrating this effectiveness to payers is crucial to shift the value equation — quality over cost — in our favor. Publishing high quality studies, such as the Sport trial, which we at Rothman Orthopaedics helped conduct, provides data to demonstrate the efficacy and cost-effectiveness of our surgeries. In our practice, we collect patient reported outcome measures on all of our patients, so that we can use these metrics to prove quality and help negotiate reimbursement.
We have also implemented containment strategies in our practice to help reign in practice-related costs. Our management team continually assesses for potential areas of waste and focuses on maximizing efficiencies within each respective department. We have also recruited the assistance of cloud-based software companies, such as Salesforce, which have optimized our patients' experience and helped mitigate costs by increasing productivity and minimizing redundancy. These upfront costs have already paid long term dividends.
Brian Gantwerker, MD. Craniospinal Center of Los Angeles: One of the main things we have focused on is cost-cutting. The last few months we have had to take a hard look at what is driving our overhead. Finding other revenue streams has been both eye-opening and depressing. What will never change is our practice's continued commitment to on-indication surgery, outcomes and maintaining a strong positive reputation in the community.
Jonathan Gottlieb, MD. Minimally Invasive Spine Center of South Florida (Miami): It is essential to focus on maintaining efficiencies and preventing revenue bleed. Closely watching augmented reality, assessing actual reimbursement versus expected and monitoring administrative costs translate directly to the bottom line. It is easy to ignore details with a fat wallet, but that wallet can lose weight quickly. I believe it also contributes to the interest many surgeons have in participating in legal cases as the reimbursement typically exceeds what we receive under conventional insurance contracts.