Spine leaders expect things like outpatient care and new technologies to grow in the specialty, but different factors such as AI and personalized tools could surprise people in the long term with their scale.
The 20 leaders featured in this article are speaking at Becker’s 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, set for June 11-13, 2026, at the Swissotel Chicago.
If you would like to join the event as a speaker, please contact Carly Behm at cbehm@beckershealthcare.com.
As part of an ongoing series, Becker’s is connecting with healthcare leaders who will speak at the event to get their insight on thought-provoking questions within the industry. The following are answers from event speakers, lightly edited for clarity.
Question: Five years from now, what changes in spine care and practice management will surprise most people in the field today?
Tan Chen, MD. Inova (Fairfax, Va.): Five years from now, spine care will feel more custom tailored. Surgery, when it’s needed, will be smaller, safer and often same-day. Care plans will be clearly mapped out and highly personalized to each patient’s biology, lifestyle and goals. Recovery will shift largely to the home, supported by real-time guidance rather than frequent office visits. The most successful practices will feel less like clinics and more like trusted partners, clear, responsive and fully invested in helping patients return to their lives.
Charlene Cioe, CNO at Summit Center for Surgery (Oakbrook Terrace, Ill.): Five years from now, I think some of the biggest surprises in spine care will come from how much technology and outpatient care continue to evolve. One change that may stand out is the growing use of artificial intelligence to support clinical decision-making. AI tools are already being developed to analyze imaging, patient history, and outcomes data, and they will likely become more common in helping providers determine which patients may benefit most from surgery versus conservative treatment. While clinical judgment will always remain essential, these tools may help guide more personalized care and reduce unnecessary procedures.
Another change that may surprise many providers is how many spine procedures will move into outpatient or ambulatory surgery center settings. As minimally invasive techniques, anesthesia practices, and pain management continue to improve, procedures that once required inpatient hospitalization may increasingly be performed safely in outpatient environments. This shift could help reduce healthcare costs while also improving recovery time and patient satisfaction.
From a practice management standpoint, value-based care will likely continue to grow. Spine practices may rely more heavily on patient-reported outcomes, quality metrics, and coordinated care models. Reimbursement may increasingly be tied to measurable results rather than the number of procedures performed.
Finally, telehealth and remote monitoring will probably become a more routine part of follow-up care. Digital tools and wearable devices may allow clinicians to track recovery and mobility more closely after surgery or therapy. Overall, these changes could reshape both how spine care is delivered and how practices manage patient care over time.
Brian Cunningham, MD. Director of ambulatory surgery at TRIA Orthopedics and vice chair and director of inpatient orthopedics at Methodist Hospital (Minneapolis): More than half of spine patients will be in risk barring payment models. Prior authorization will give way to alignment on outcomes and resource utilization. Everything will move downstream with large payments at risk for practices.
Antoine Curtis. Vice president of neurosciences at UChicago Medicine: In five years, advancements in technology, particularly artificial intelligence and telemedicine, will revolutionize spine care, allowing for more personalized and efficient treatment plans. The integration of wearable devices for real-time monitoring will enable practitioners to track patient progress remotely, leading to better outcomes. Additionally, the industry will see a significant emphasis on reducing the overall cost of care, prompting practitioners to adopt value-based care models that prioritize patient outcomes and satisfaction. Furthermore, the focus on holistic and multidisciplinary approaches will challenge traditional treatment paradigms, emphasizing prevention and wellness over reactive care.
Tina DiMariano, DNP, RN. CEO (Custom Surgical Partners): I think it will be the advancements in both technology and AI. AI is going to enhance technology and those enhancements are currently unimaginable and moving forward exponentially. From the practice perspective, I believe there will be so much administrative work that is automated. Many of the repetitive, mundane tasks will be done by AI. This will be a win, overall to free up time for tasks that require strategic thinking.
Travis Doering, MD. Bone Drs. Orthopedic Care (Austin, Texas): If the Same Care, Lower Cost Act passes, it may quietly be the biggest structural surprise in practice management in a generation — collapsing the economic rationale for the employed model overnight. But the more likely answer is that AI will become pervasive across every aspect of medicine, and current models — with far more capable ones already in development — will level the playing field in ways that make solo and small-group practice not just viable, but genuinely competitive. The independent physician who builds correctly now may end up with lower overhead, faster adaptation, and better outcomes data than the health system down the street.
Bruce Feldman. Former Administrator of Eastern Orange Ambulatory Surgery Center and Founder of an ASC Consulting Firm (Cornwall, N.Y.): I think we’re going to see more complex and higher acuity spine surgery being done in the ASC setting. Innovations in healthcare technology such as the use of AI will allow for more precision surgical techniques to be performed, which will shorten procedure/operative time and recovery. Knowing your procedure costs will become more and more important regarding contract negotiations with insurance companies.
Megan Friedman, DO. Chair and medical director at Pacific Coast Anesthesia Consultants (Los Angeles): Most people expect clinical innovation to drive change, but the bigger shift will be operational. More complex spine [surgeries] will move into ASCs, but success will depend on predictable scheduling, aligned incentives and stable anesthesia coverage. The surprise won’t be what cases can be done, it will be which organizations can actually run them efficiently.
Vamsi Kancherla, MD. Specialty Orthopaedics (Gainesville, Ga.): By 2031, AI-powered robotics and predictive analytics will make even complex spine procedures — like multilevel fusions — routine in ASCs with near-zero complications and same-day discharges, shocking those who still see them as inpatient-only. Regenerative biologics and motion-preserving tech will increasingly replace traditional fusions for many degenerative cases, challenging today’s hardware-heavy defaults.
Practice management will flip toward physician-owned ASC dominance, fueled by site-neutral payments and value-based models, granting surgeons far greater independence than today’s hospital consolidation trends suggest.
Michael Lewis, MD. Henry Ford Health (Detroit): If you asked most of us right now, we’d probably still say anesthesia is mostly about what happens in the OR. I don’t think that will feel true in five years. What’s going to surprise people is how much more of our work happens before and after surgery, especially for higher-risk patients. Anesthesiologists will be getting involved earlier, helping determine whether someone is optimized for surgery, or even if surgery is the right path. That alone will cut down a lot of the “day-of” commotion to which we’ve become accustomed. And our work won’t just stop once the case is over. There’s going to be more follow-through, including keeping tabs on recovery, complications, and outcomes once patients leave the immediate perioperative window.
I think overall, the biggest change will be how we’re perceived five years from now. Instead of being the team that shows up for the procedure, anesthesia is going to be recognized as a continuous partner in the patient’s care. That’s a vastly different identity than what most of us trained with.
Andrew Lovewell. CEO at Columbia (Mo.) Orthopaedic Group: Five years from now, spine care and practice management are going to look quite a bit different. Non-operative spine care will continue to have massive growth in the future. Not because surgery disappears, but because it gets more selective, and models like ASM will limit the ability or timeline for operations. Advanced diagnostics, better biologics, and high-functioning MSK care pathways will be the play in the future. The winners will be groups that own the entire full care continuum: PT, injections, imaging, remote patient options, not just the surgical event.
In addition, the cases being performed in the hospitals today will continue migrating to ASCs at scale. Not because the outcomes are poor, but because the economics will force the migration. Minimally invasive spine is going to look a lot more like joints did 10-15 years ago. If you don’t control or partner in an ASC, you’ll feel it in both volume and margin.
The business model shifts from volume to managed outcomes. Call it bundles, call it value-based, call it risk-sharing, it’s coming whether people like it or not (prime evidence is ASM from Medicare for 2027). The groups that can track outcomes, standardize pathways, and prove cost efficiency will win contracts. Everyone else becomes beholden to the price and takes what they get. I also look for independent groups to either get bigger or get squeezed out. Mid-sized practices that don’t have ancillaries, data, or negotiating leverage will feel pressure from both PE-backed platforms and health systems.
Cheraire Lyons, PhD. Vice president of revenue cycle at Alliance Spine & Pain Centers (Atlanta): Over the next five years, spine care will move from early AI adoption to fully AI‑enabled operations. Intelligent documentation, predictive RCM driven by real‑time KPIs, and unified technology platforms will significantly reduce administrative burden and strengthen financial performance. At the same time, patient engagement will advance through personalized digital experiences that expand access and improve continuity of care, creating a smarter, more connected, and more patient‑centered spine care environment.
Paul Lynch, MD. Founder and CEO, US Pain Care (Phoenix): Five years from now, what will surprise most people is how quickly musculoskeletal and pain care — now exceeding $1 trillion annually when you include joints, spine, mental health, and opioid use disorder — shifts toward true value-based models. These will not be pilot programs, but full-risk, capitated contracts that reward groups capable of managing the entire patient journey. What’s not yet on many people’s radar is that this transition will require a return to physician ownership, with tighter alignment between clinic practices and surgery centers.
The groups that succeed will be those led by physicians who integrate care delivery across settings and take accountability for both outcomes and cost. At U.S. Pain Care, this is exactly the model we are building — empowering physician owners to serve as the gatekeepers of the future MSK and pain spend.
Rory Murphy, MD. Barrow Neurological Institute (Phoenix): Over the next five years, all spine and orthopedic implants will become intelligent, connected devices — not passive hardware. Companies like Intelligent Implants are already developing systems that stimulate, accelerate, and measure bone growth in real time via cloud platforms, while Canary Medical has shown implants can continuously transmit functional recovery data after surgery. This will converge with neuromodulation and brain-computer interfaces, enabling restoration of function — even in paralysis — within ASC-based models. The surprise won’t be the technology itself, but how quickly we have enabling technology.
Ronjon Paul, MD. Endeavor Health Medical Group (Schaumburg, Ill.): What will surprise many people is that the next major advance in spine care may be in practice management as much as in the operating room. Robotics, navigation and AI will continue to improve technical precision, but the real differentiator will be the ability to deliver truly personalized care — using data, predictive analytics and patient-specific pathways to guide the right treatment for the right patient at the right time. At the same time, we will see more spine care shift into highly organized outpatient and ASC-based models supported by standardized protocols and robust digital infrastructure. The groups that thrive will be those that combine technical excellence with personalization, while building disciplined systems around access, communication and longitudinal care.
Mick Perez-Cruet, MD. Michigan Minimally Invasive Neurosurgical Institute (Waterford): The biggest change will be that most spine cases will be performed using minimally invasive techniques and technology. Most cases will be performed in surgeon-owned ASCs or hospitals. Many will utilize augmented reality that preserves normal anatomical form and function while allowing surgeons to see all the 3D anatomy of the spine. Regenerative spine technologies that reverses disc degeneration and that restores normal intervertebral function will be on the forefront.
Melissa Rice. Administrator at Loyola Ambulatory Surgery Center, part of Trinity Health (Oakbrook Terrace, Ill.): Five years from now, one of the most surprising changes in spine care will be how quickly care has shifted out of the hospital and into high-performing ambulatory settings. Advances in minimally invasive techniques, anesthesia protocols, and post-op pain management will make same day discharge the norm rather than the exception for many spine procedures.
Data-driven decision-making will play a much larger role, with real-time outcomes, cost transparency, and patient-reported metrics guiding both clinical and operational choices. Artificial intelligence will increasingly support preoperative planning, case selection, and documentation, reducing variability and administrative burden for providers. From a practice management standpoint, spine programs will look less like traditional physician practices and more like integrated service lines with strong operational leadership. Alignment between surgeons, ASCs, anesthesia, and technology partners will be essential for sustainability.
Reimbursement pressure will accelerate the need for efficiency, forcing practices to better understand cost per case and margin by procedure. Workforce models will evolve as well, with greater reliance on advanced practice providers and cross-trained staff. Patients will also expect a more consumer-centric experience, including digital engagement and predictable pricing. Ultimately, the biggest surprise may be how quickly adaptability becomes the defining trait of successful spine practices.
Ken Rich, MD. President of Raleigh (N.C.) Neurosurgical Clinic: I think the type of cases we can do in an ASC are going to grow over the next five years. Hopefully insurers will keep up with approving movement of those cases from the hospital setting. What we can do outside of hospitals and in ASCs would make a huge difference in the economics of spine care.
David Russo, DO. Columbia Pain Management (Hood River, Ore.): Five years from now, what will surprise most people isn’t a new device; it’s how incentives will have shifted. We’ll see a major change in spine care from hospital systems to physician-led ASCs, driven by site-neutral payment pressures and increased cost transparency. AI won’t replace physicians, but it will quietly improve and transform everything from documentation to prior authorization to risk stratification, easing processes in some areas while increasing payer control in others. The biggest surprise, however, will be the comeback of independent, physician-led practices that have figured out how to grow without giving up control, by combining operational discipline with aligned incentives. In other words: less consolidation than expected, but more polarization between top-tier independents and everyone else.
Erica Taylor, MD. Duke University (Durham, N.C.): Five years from now, the biggest surprise in spine care will not be a new device or technique. It will be how much care delivery has shifted upstream. Risk stratification, social drivers of health, and predictive analytics will be embedded into surgical decision-making, not layered on afterward. Practices that integrate access, optimization, and longitudinal care coordination will outperform those that remain procedure-centric.
On the practice management side, the real shift will be cultural. High-performing spine programs will look less like siloed surgical groups and more like integrated value platforms, where surgeons, advanced practice providers, rehabilitation teams, and data analysts operate as one unit aligned around outcomes and cost accountability.
The surprise will not be the technology. It will be the operational discipline and leadership required to make it work.
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 18–20 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
