Spine and orthopedic physician advocacy is a more integral part of the healthcare landscape, and Michael Briseño, MD, said it can no longer be a “side project.”
Dr. Briseño is a spine surgeon with United Musculoskeletal Partners, which partnered with the American Independent Medical Practice Association. As part of the partnership, he’ll be on the AIMPA’s board of directors.
Dr. Briseño shared his physician advocacy goals with Becker’s.
Note: Responses were lightly edited.
Question: What are your top three priorities for spine surgeon advocacy in 2026?
Dr. Michael Briseño: Our top priority will be fair reimbursement that reflects complexity and outcomes, not just volume. Orthopedic procedures continue to advance clinically, yet reimbursement often lags both in terms of inflation and complexity. Advocacy will focus on protecting independent practices from policy frameworks that unintentionally incentivize consolidation rather than rewarding high-value care.
Second, prior authorization reform as musculoskeletal care is one of the most burdened specialties when it comes to utilization management, which directly delays care for patients dealing with pain and functional issues. Our advocacy in 2026 will push for standardized, evidence-based prior authorization with real accountability for delays and denials.
Third, continue to advocate for site-of-care neutrality. AIMPA has been focused on this issue since its inception and now that UMP has joined AIMPA, we will help amplify the voice of musculoskeletal specialists across the country. We believe orthopedic surgeons should be able to deliver care in the most clinically appropriate and cost-effective setting, whether that’s an ASC, hospital outpatient department or office-based suite without reimbursement or regulatory bias steering clinical decisions.
Q: How do you balance advocacy with growth and operational demands inside an organization like UMP, especially as regulatory complexity continues to increase?
MB: The key is treating advocacy as part of our infrastructure and not a side project. For UMP, advocacy is directly connected to operational realities such as reimbursement, staffing and patient access.
Growth without advocacy can become disjointed as regulatory complexity affects everything from ASC utilization to care coordination and physician compensation. By aligning advocacy priorities with real operational pain points, we ensure that growth strategies remain sustainable instead of reactive.
Q: Where do independent MSK practices currently have the biggest disadvantage compared to hospital-employed groups? How can groups like AIMPA level the playing field?
MB: Independent practices often deliver high-quality care at lower cost, but hospital-employed groups benefit from site-based payment advantages, scale leverage in negotiations and regulatory carve-outs. Therefore, the biggest disadvantage is policy asymmetry, not clinical capability.
Organizations like AIMPA can help level the playing field by unifying independent voices across specialties and compiling meaningful data to further reinforce to policymakers that independence improves access, lowers total cost of care and maintains physician accountability without forcing consolidation as the default solution.
Q: How do you envision UMP leveraging AIMPA’s multispecialty reach to influence musculoskeletal-specific issues like reimbursement, site-of-care decisions, and prior authorization?
MB: The real power is in connecting the data collected by UMP’s National Physician Leadership Board to broader AIMPA policy narratives. The challenges facing musculoskeletal practices are ubiquitous across other specialties. Prior authorization, reimbursement and site-of-care decisions also affect cardiology, gastroenterology, ophthalmology and countless other specialties represented across AIMPA physician members.
By leveraging AIMPA’s multispecialty reach, UMP can frame musculoskeletal issues as systemwide efficiency opportunities rather than specialty-specific issues. In turn, this will create a more united narrative, which will be easier for policymakers to support.
Q: What message do you think policymakers still misunderstand about independent practices, particularly in spine and orthopedics, that AIMPA is well-positioned to correct?
MB: The biggest misconception is that independence equals fragmentation when, in reality, independent musculoskeletal practices are often the most coordinated, accountable and outcomes-driven specialists in their markets.
Policymakers frequently assume consolidation of independent practices into health systems leads to increased efficiency, however that has not always been proven true. AIMPA represents more than 600 medical practices, including those within UMP and is therefore uniquely positioned to correct that narrative by presenting independence as a policy solution, not a problem to be solved.
The message is simple: protecting independent practices ensures patient access, physician accountability and long-term sustainability of the healthcare ecosystem.
