3 trends top of mind for spine surgeons

Alan Condon -   Print  |
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Increasing regulatory changes, the spread of the COVID-19 delta variant and continued reimbursement cuts are top of mind for spine surgeons in the remaining months of the year.

1. Regulatory changes

For many spine surgeons, particularly those practicing with smaller organizations, regulatory changes related to commercial payers and CMS are a significant pain point. Such changes create added administrative burdens for these practices, which can affect employee satisfaction and "add little if any value to patient care," Richard Kube, MD, of Prairie Spine in Peoria, Ill., told Becker's.

Many surgeons view the preauthorization process as a flawed system that delays patient care and hampers practice workflow and efficiency. "Sometimes the guidelines do not make sense, and there is not enough flexibility built into the guidelines to allow a patient to proceed with surgery if they do not meet criteria," according to Alok Sharan, MD, of NJ Spine and Wellness in East Brunswick, N.J. "Unfortunately, much of medicine — spine surgery in particular — is not so cookie-cutter that we can make rules on who needs/doesn't need spine surgery."

2. Delta variant

The biggest concern over the next six months will remain the spread of the delta variant and how the spike in cases will affect staffing, hospital beds and the ability to perform elective surgeries. As coronavirus infection rates increase in many parts of the country, the surgeon community is urging people to get vaccinated to prevent hospitals from being overwhelmed and allowing for the continuation of many services, including surgeries.  

"My biggest concern is getting unvaccinated people vaccinated for COVID-19 because as it happens across the country, hospital beds are filling up, causing spine surgeries to stop as there are no beds for surgery patients," said Plas James, MD, of Atlanta Spine Institute. "Another concern is children getting COVID-19 by going back to school without wearing masks and bringing it home to their parents who then get sick. The world getting vaccinated is key to keeping us from shutting down nationally, especially in hospitals."

3. Reimbursement cuts

The continued reduction in reimbursement for spine procedures remains a key concern for surgeons, many of whom are dealing with increased costs while addressing the various practice challenges brought by the coronavirus pandemic. More Medicare cuts are likely on the way for 2022, and commercial payers are likely to follow suit.

"Every year we see insurance companies cutting reimbursement while our expenses increase," said John Dickerson, MD, of Kansas Spine & Specialty Hospital in Wichita. "Also, we are seeing an upsurge in the number of denials. Denial management within the practice eats up resources, and — more importantly — it's not good for the patient."

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