• 'The numbers don't lie': Endoscopy to become more prominent among next generation of spine surgeons
  • Minnesota orthopedic group hit with $111M negligence verdict
  • Orthopedic patient's death highlights potential dangers of prior authorization
  • Spine surgeon killed in Oklahoma hospital shooting
  • Neurosurgeon accepted $3.3M in illegal payments to perform spine surgeries at hospital
  • Spine surgeon gets jail time for abusing patient during hospital visit
  • Providence to pay $22.7M to settle unnecessary spine surgery allegations
  • Texas spine surgeon defending himself from 'Dr. Death 2.0' allegations
  • 'They're on really thin ice': Why 1 insurer has drawn spine surgeons' ire
  • Orthopedic surgeon must face suit in patient's death
  • Spine surgeon 1 of 9 physician billionaires on Forbes' 2022 list
  • Connecticut hospital to appeal $12.5M verdict to family of patient who died after orthopedic surgery
  • 4 spine technologies that promised more than they delivered
  • Orthopedic surgeon's health system exit steeped in controversy
  • Terminated orthopedic surgeon contracts with another New York hospital
  • Texas spine surgeon sued by State Farm over 'unnecessary' procedures
  • 22 hospitals ranked top 25 orthopedic hospitals 3+ years in a row
  • Orthopedic surgeon convicted of battery at hospital
  • UArizona neurosurgery chair dies after motorcycle collision
  • America's largest independent practices by number of spine surgeons
  • Could Medtronic's spine business be the next medtech spinoff?
  • 41 'rising stars' in orthopedics
  • Idaho orthopedic surgeon arrested for alleged misconduct at practice
  • Neurosurgeon's startup hits $1.2B valuation
  • Orthopedic surgeon indicted in $10M telemedicine fraud scheme
  • Orthopedic surgeon salaries in the 5 best, worst states for healthcare
  • New Jersey hospital must pay neurosurgeons $24.3M, appeals court rules
  • Good news, bad news for orthopedic surgeons: 6 observations
  • Why private equity is bettering orthopedics, 3 physician leaders say
  • Florida hospital patients say they were injured during surgeries. Now a physician faces 350 lawsuits.
  • Texas spine surgeon's $11M verdict being appealed
  • A Rutgers physician accused of 'ghost surgeries' will return — but with fewer responsibilities
  • Top orthopedic hospital in every state: US News
  • Rothman Orthopaedics to become national brand, but no 'aspirations to go beyond US'
  • Sports medicine physician fired amid misconduct allegations involving patients
  • Orthopedic surgeon asking for misconduct charges to be dropped
  • Unnecessary spine cases spur class action lawsuit
  • Colorado Supreme Court rejects hospital's bid to enforce $229K spine surgery bill
  • Jury finds neurosurgeon largely responsible for paralysis, awards $15.5M in damages
  • Dr. Jon Yoon performs NHL's 4th disc replacement in 7 months
  • 'The numbers don't lie': Endoscopy to become more prominent among next generation of spine surgeons
  • Neurosurgeon accepted $3.3M in illegal payments to perform spine surgeries at hospital
  • Carson Daly has 2nd spine procedure in 3 months
  • Spine surgeon steps down as CEO of biologics company
  • 2 professional athletes undergo spine surgery in a week
  • How key spine trends are shaping up in 2021

    How key spine trends are shaping up in 2021

    Alan Condon -  

    Downward pressure on reimbursement, rising consolidation and rapid outpatient migration are some of the key trends affecting the spine field.

    While the Coronavirus Aid, Relief, and Economic Security Act provided critical economic relief to many orthopedic practices last year, surgeons knew that government funding would come at a price.

    CMS reimbursement and physician fee cuts were expected for 2021, but many providers were shocked at how steep they were — initially an up to 10.2 percent decrease in reimbursement for some specialists.

    Last month, however, CMS updated the Physician Fee Schedule to reflect the changes in the Consolidated Appropriations Act. The revised conversion factor for 2021 is $34.89, 3.3 percent less than the conversion factor in 2020.

    Though the most recent COVID-19 stimulus package has mitigated CMS cuts, many surgeons fear more could be on the horizon from CMS and commercial payers.

    "The hamster wheel is going to get driven faster for less," Lali Sekhon, MD, PhD, of Reno (Nev.) Orthopedic Center, told Becker's. "With so much money spent at a state and federal level on COVID relief, reducing payments for Medicaid and Medicare are in the pipeline."

    One strategy providers are increasingly adopting to address economic challenges is banding together to form larger groups. Over the past year, the orthopedic field has seen three supergroups of 100-plus physicians created through mergers in Florida, Tennessee and Texas.

    Although the pandemic somewhat stifled innovation last year, navigation, robotics and augmented reality technologies continue to make noise in spine.

    But hospitals and health systems may be less willing to fork out capital for the next "game changer" given the challenging economic climate and accelerating outpatient migration. Smaller device companies will likely feel the pinch as hospitals look to reduce costs wherever possible.

    "Medical device companies will have to adapt to this new normal and offer services to surgeons to help them transition their practice to the outpatient space," said Alok Sharan, MD, of NJ Spine and Wellness in East Brunswick. Such services include AR/virtual reality technologies to train surgeons and staff, along with digital tools to facilitate remote patient monitoring.

    More ASCs will likely invest in robotics as hospitals expect to lose an increasing number of spine cases over the next five years, according to Vladimir Sinkov, MD, of Sinkov Spine Center in Las Vegas.

    "Hospitals still have a lot of capital they can invest, where surgery centers are typically starved of capital, which is why it makes sense to partner," Dr. Sinkov said. "In my opinion, outpatient migration of spine surgery will encourage surgery centers to rent or purchase surgical robots and other advanced technology to drive that exodus even faster."

    For hospitals, the issue now is the value on investment, according to Martin Roche, MD, of Hospital for Special Surgery in West Palm Beach, Fla.

    "The key now will be how companies sell their robots both to hospitals and to ASCs," Dr. Roche said. "Right now, as surgeons are investors in ASCs, they're going to be more introspective on how much money they put up front.

    "In certain cases the business model of how companies are selling robots will change. They may link it to how many cases you do, which can help pay it down, and develop various 'at risk' models. I think orthopedic companies are drawing up different types of business models because they see robotics as the future as well."

    All these factors are likely to accelerate the trend toward outpatient surgery, in addition to new prior authorization requirements and CMS and commercial payers encouraging more cases to be done at ASCs.

    One thing is for certain: The future is bright for the ASC industry, which continues to bring cases to the outpatient setting.

    Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

    Featured Webinars

    Featured Podcast

    Featured Whitepapers